This is a rare type of memory disorder caused by a lack of thiamin (also called vitamin B1). It is called Wernicke-Korsakoff syndrome (WKS), and without treatment, it can be fatal. Usually, people who experience alcohol addiction develop this syndrome. While it cannot be cured, doctors recommend some treatments that improve the symptoms and reduce the risk of developing serious complications.
In general, thiamin is a crucial vitamin that the body uses to convert food into energy. This syndrome consists of 2 stages. For example:
- Wernicke encephalopathy – In such cases, people experience a sudden and severe brain disorder.
- Korsakoff syndrome – This is a long-term (chronic) memory disorder.
The name for this brain and memory disorder comes from the German neurologist Carl Wernicke and the Russian neuropsychiatrist Sergei Korsakoff.
Are There Other Conditions Like Wernicke-Korsakoff Syndrome?
There are some diseases that may also occur due to a lack of thiamin. Check below some examples:
- Central pontine myelolysis (CPM)
- Leigh’s disease
- Nutritional optic neuropathy
- Beriberi
- African seasonal ataxia
This condition affects approximately 2% of people in the entire world. However, roughly 50% of people with Wernicke encephalopathy develop Korsakoff syndrome. Moreover, the risk of developing this syndrome increases to 80% in people with alcohol use disorder.
Symptoms
This syndrome usually causes different symptoms among people who experience it. One of the most common symptoms is confabulation. Those who experience it begin to invent information to cover memory loss. However, this common symptom happens only in severe cases.
Some people with WKS may be confused or disoriented, which makes it challenging to realize anything is wrong or seek treatment. Check below some common symptoms that people with Wernicke encephalopathy experience:
- Balance problems or loss of coordination
- Delirium
- Drowsiness
- Unsteady gait (walking problems)
- Hypothermia (reduced body temperature)
- Ataxia (lack of muscle coordination)
- Hypotension (low blood pressure)
- Heart problems (such as tachycardia)
Furthermore, people with WKS may also develop eye problems. These include:
- Nystagmus (unusual eye movement)
- Double vision
- Ophthalmoplegia (eye muscle paralysis or weakness)
- Ptosis (drooping eyelids)
Usually, people who ignore the symptoms or do not realize they have a problem develop Korsakoff syndrome (a chronic form of memory loss). It may cause other symptoms different from Wernicke encephalopathy. These include:
- Extreme tiredness (fatigue)
- Lethargy
- Lack of focus or attention
- Hallucinations
- Behavioral changes (including anger, agitation, and others)
- Amnesia (this is a condition in which people cannot form new memories)
While some symptoms may improve on their own, others require immediate treatment. Otherwise, it may lead to severe symptoms such as coma. Seek emergency care if you think a loved one experiences this syndrome.
Causes
People develop this syndrome due to a lack of thiamin (vitamin B1), which plays an important role in converting sugar into energy. When levels of vitamin B1 are low, the brain does not get enough energy required to work properly.
One of the most common causes of thiamine deficiency is chronic alcohol use. However, alcohol prevents the ability of body from absorbing vitamin B1 and storing it in the liver. Over time, levels of thiamin decrease and may cause multiple health problems, not only WKS. Check below for other causes of WKS:
- Poor nutrition
- Eating disorders
- Chronic infections
- Surgery, such as gastric bypass surgery done for weight loss
- Traumatic brain injury (rarely causes WKS)
Risk Factors
While the most common cause of Wernicke-Korsakoff syndrome is alcohol use disorder, it may occur due to other factors. Other risk factors include:
- Sex – Usually, this syndrome occurs in men than women.
- Age – It is often diagnosed between the ages of 30 and 70 in men, especially if they regularly drink alcoholic beverages.
- Bowel or stomach diseases – These include inflammatory bowel disease (IBD), gastropathy, and others.
- Certain types of cancer, especially in advanced stages
- Thyrotoxicosis – This is a condition in which levels of thyroid hormone become extremely high.
- Heart failure
- HIV/AIDS
- Kidney failure – This condition needs long-term dialysis to help the kidneys remove waste from the body. However, dialysis prevents normal thiamin absorption.
- Poor nutrition
- Hyperemesis gravidarum – Severe nausea and vomiting during pregnancy.
What Are The Potential Complications of Wernicke-Korsakoff Syndrome?
People with this condition may experience life-threatening complications, especially if they do not get treatment. Check below some examples:
- Permanent neuropathy – Continuous damage to the nerves may cause numbness, weakness, and pain.
- Cognitive impairment – Those who develop this complication often experience problems with planning, problem-solving, and thinking.
- Personality changes – These include irritability, apathy, decreased emotional expressions, and others.
- Reduced lifespan – In severe cases, WKS may lead to a decreased life expectancy.
- Permanent memory loss – In advanced stages, this syndrome may cause severe memory impairment and inability to make new memories or recall past events.
- Cardiovascular problems – For example, coronary artery disease, hypertension (high blood pressure), heart failure, and others.
- Diabetes
- Increased risk of falls and trauma due to ataxia and cognitive impairment.
This document does not contain all possible complications of WKS. However, if you or a loved one experiences any of the previous ones, go to the nearest emergency room or call 911 in the U.S.
How to Prevent Wernicke-Korsakoff Syndrome?
Unfortunately, there is no sure way to prevent this syndrome. However, to reduce the risk of developing it, doctors may recommend avoiding alcoholic drinks, dietary changes, and supplements (thiamin injection or tablets).
Diagnosis
The only way to reduce the risk of complications and make an effective treatment plan is early diagnosis. First, doctors perform a physical examination to check for abnormalities linked to the disease. Thereafter, they may ask some questions about the symptoms and family history. Sometimes, it is challenging to diagnose WKS, especially if people have mental confusion or memory loss. Moreover, it is very important to inform your doctor if you experience thiamine deficiency, malnutrition, or alcohol use disorder.
In addition, physicians usually perform some blood tests to check levels of vitamin B1 and blood sugar. Check below for other tests done to exclude other conditions that cause similar symptoms:
- Arterial blood gas (ABG) test – This test is used to measure carbon dioxide and oxygen levels in the blood.
- Complete blood count (CBC)
- Toxicology (drug) screening
- Imaging tests – Doctors usually perform a CT (computed tomography) or MRI (magnetic resonance imaging) scan.
- Electrocardiogram (EKG or ECG) – This is a painless and quick test that helps measure the electrical activity of the heart. It may help identify heart problems.
Treatment
While the condition cannot be cured, the treatment focuses on relieving the symptoms and reducing the risk of life-threatening complications. With immediate treatment, most people do not develop Korsakoff syndrome. Furthermore, treatment can reverse or slow the progression of the disease and its symptoms. For example, eye problems, muscle coordination, and confusion. Check below for the most common treatments recommended for people with WKS:
- IV (intravenous) fluids – This treatment helps prevent to treat dehydration.
- Nutritional support
- Medicines
- Alcohol use disorder treatments
- Vitamin B1 injections or tablets
Frequently Asked Questions
What happens if Wernicke-Korsakoff is left untreated?
People who ignore the symptoms and do not get immediate treatment may experience permanent damage to the brain or even death.
What is the cause of WKS syndrome?
The primary cause of this syndrome is alcohol use disorder. However, there are some causes that may also cause Wernicke-Korsakoff syndrome. For example:
- Long-term (chronic) infections
- Gastric bypass surgery
- Head injuries
- Eating disorders (such as bulimia, anorexia nervosa, and others)
- Malnutrition
If you think a loved one experiences symptoms of WKS, immediately go to the nearest emergency room.
What is end-stage Korsakoff syndrome?
Sometimes, WKS is called alcohol dementia, and it often happens in people with end-stage alcoholism. Ask your healthcare provider if you have any other questions.
