Wernicke-Korsakoff Syndrome & Alcohol Abuse
Wernicke-Korsakoff syndrome, also known as wet brain, is a combination of two diseases: Wernicke encephalopathy and Korsakoff’s psychosis. People develop Wernicke-Korsakoff syndrome due to the lack of thiamine, also known as vitamin B1. About one to two percent of people in the U.S. develop this disease, with men between 30 to 70 years old slightly at more risk than women of the same age group.
The two conditions relate to each other in various ways. Wernicke encephalopathy usually develops first, causing damage to the thalamus and hypothalamus found in the brain. When those parts of the brain are damaged, Korsakoff’s psychosis will typically develop. In addition, as Korsakoff’s psychosis symptoms increase, Wernicke encephalopathy symptoms tend to subdue. If a person successfully gets treatment for Wernicke encephalopathy, Korsakoff’s psychosis may not develop.
It’s worth noting that Wernicke-Korsakoff syndrome can occur for any reason that leads to vitamin B1 deficiency. Examples include bariatric surgery, gastric cancer or issues with the stomach and intestine that make it difficult to absorb nutrients.
Associated Symptoms
While the two are separate conditions with a different set of symptoms, Wernicke encephalopathy and Korsakoff’s psychosis often develop concurrently. Below are the symptoms for both conditions:
Wernicke encephalopathy
- Alcohol withdrawal
- Coma
- Extreme confusion
- Loss of mental activity
- Loss of muscle coordination
- Vision changes such as double vision
Korsakoff’s psychosis
- Difficulty remembering events
- Inability to create new memories
- Loss of past memories
- Making up stories to replace lost memories; also known as confabulation
- Hallucinations
Of note, after a person is diagnosed with both conditions, they are also at risk of falling after passing out, suffering heart problems due to rapid heart rate and low blood pressure when standing.
While there are rare instances in which a person may be cured of the disease without seeking treatment, the person runs the risk of permanent damage to the brain which can lead to death. Untreated Wernicke-Korsakoff syndrome could result in:
- Alcoholic neuropathy, or permanent nerve damage
- Alcohol withdrawal, which can be life-threatening without proper medical supervision
- Injury from falling
- Permanent loss of memories and cognitive ability
- Shortened life span
- Trouble with socializing
Wernicke-Korsakoff Syndrome and Alcohol Abuse
In developed countries, alcohol use disorder (AUD) is the top reason for Wernicke-Korsakoff syndrome cases. The Centers for Disease Control and Prevention (CDC) reports that about 88,000 people die every year from complications involving alcohol abuse, with Wernicke-Korsakoff syndrome a clear example of that. In addition, roughly 12 to 14 percent of people who consume large amounts of alcohol are at risk of getting Wernicke-Korsakoff syndrome.
The National Institute on Alcohol Abuse and Alcoholism revealed brain damage from Wernicke-Korsakoff syndrome correlates to how much and how frequently a person drinks. The age the person started drinking along with how long the person has been drinking plays a role as well, along with a person’s gender or age. People who have a family history of alcoholism are also more likely to develop the disease. In addition, people who were exposed to alcohol while in the womb have a greater chance of developing Wernicke-Korsakoff syndrome.
It’s also worth understanding the relationship between thiamine and alcohol. When someone excessively and consistently drinks alcohol, it interferes with how thiamine is absorbed by their gastrointestinal tract. As a result, the liver has a difficult time storing the vitamin. Due to the lack of thiamine, the organ system has a difficult time functioning, especially the brain.
Diagnosis & Treatment
There are several procedures involved when diagnosing Wernicke-Korsakoff syndrome. They include:
- Blood tests to see how much thiamine is in the body and how well the liver and kidneys are working
- Imaging scans of the brain like an MRI to rule out problems like a tumor or stroke
- Eye exams to check eye movement
- Mental health exams
- Tests to check the brain and nervous system
- Tests to look at changes in how the walk
Many people who are diagnosed with Wernicke-Korsakoff syndrome require treatment in an institutional setting like a hospital. Proper treatment can take years and require extended periods of sobriety.
Typically, people with Wernicke-Korsakoff syndrome who get medical treatment will receive thiamin and magnesium through the vein. After proper treatment, patients should see improvement within two to three weeks. Although there are other forms of treatments, the most effective concurrent method should be ending physical dependence on alcohol so the person can remain sober while recovering from Wernicke-Korsakoff syndrome.
At the end of the day, abstaining from alcohol use is the only way to prevent Wernicke-Korsakoff syndrome associated with alcohol abuse. While it can be daunting to not only treat Wernicke-Korsakoff syndrome but also tackle alcohol addiction, the process doesn’t have to be handled alone. With proper guidance from medical professionals along with the support of friends and family, the road to recovery for both Wernicke-Korsakoff syndrome and alcohol addiction can be achieved.
