Locations Main Campus: Chesterfield, MO 63017   |   Locations
314-434-1500 314-434-1500   |   Contact Us

Multimedia Encyclopedia

BACK
TO
TOP
 
E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

Wernicke-Korsakoff syndrome

Korsakoff psychosis; Alcoholic encephalopathy; Encephalopathy - alcoholic; Wernicke's disease; Alcohol use - Wernicke; Alcoholism - Wernicke; Thiamine deficiency - Wernicke

 

Wernicke-Korsakoff syndrome is a brain disorder due to vitamin B1 (thiamine) deficiency .

Causes

 

Wernicke encephalopathy and Korsakoff syndrome are different conditions that often occur together. Both are due to brain damage caused by a lack of vitamin B1.

Lack of vitamin B1 is common in people who have alcohol use disorder . It is also common in people whose bodies do not absorb food properly (malabsorption). This can sometimes occur with a chronic illness or after weight-loss (bariatric) surgery.

Korsakoff syndrome, or Korsakoff psychosis, tends to develop as Wernicke symptoms go away. Wernicke encephalopathy causes brain damage in lower parts of the brain called the thalamus and hypothalamus. Korsakoff psychosis results from permanent damage to areas of the brain involved with memory.

 

Symptoms

 

Symptoms of Wernicke encephalopathy include:

  • Confusion and loss of mental activity that can progress to coma and death
  • Loss of muscle coordination (ataxia) that can cause leg tremor
  • Vision changes such as abnormal eye movements (back and forth movements called nystagmus), double vision , eyelid drooping
  • Alcohol withdrawal

Symptoms of Korsakoff syndrome:

  • Inability to form new memories
  • Loss of memory, can be severe
  • Making up stories (confabulation)
  • Seeing or hearing things that are not really there ( hallucinations )

 

Exams and Tests

 

Examination of the nervous/muscular system may show damage to many nerve systems:

  • Abnormal eye movement
  • Decreased or abnormal reflexes
  • Fast pulse (heart rate)
  • Low blood pressure
  • Low body temperature
  • Muscle weakness and atrophy ( loss of tissue mass )
  • Problems with walk (gait) and coordination

The person may appear poorly nourished. The following tests are used to check a person's nutrition level:

  • Serum albumin (relates to person's general nutrition)
  • Serum vitamin B1 levels
  • Transketolase activity in red blood cells (reduced in people with thiamine deficiency)

Liver enzymes may be high in people with a history of long-term alcohol abuse.

Other conditions that may cause vitamin B1 deficiency include:

  • HIV/AIDS
  • Cancers that have spread throughout the body
  • Extreme nausea and vomiting during pregnancy ( hyperemesis gravidarum )
  • Heart failure (when treated with long-term diuretic therapy)
  • Long periods of intravenous (IV) therapy without receiving thiamine supplements
  • Long-term dialysis
  • Very high thyroid hormone levels ( thyrotoxicosis )

A brain MRI may show changes in the tissue of the brain. But if Wernicke-Korsakoff syndrome is suspected, treatment should start immediately. Usually a brain MRI exam is not needed.

 

Treatment

 

The goals of treatment are to control symptoms and to prevent the disorder from getting worse. Some people may need to stay in the hospital early in the condition to help control symptoms.

Monitoring and special care may be needed if the person is:

  • In a coma
  • Lethargic
  • Unconscious

Vitamin B1 may be given by injection into a vein or a muscle, or by mouth. This may improve symptoms of:

  • Confusion or delirium
  • Difficulties with vision and eye movement
  • Lack of muscle coordination

Vitamin B1 often does not improve loss of memory and intellect that occur with Korsakoff psychosis.

Stopping alcohol use can prevent more loss of brain function and damage to nerves. A well-balanced, nourishing diet can help, but it is not a substitute for stopping alcohol use.

 

Outlook (Prognosis)

 

Without treatment, Wernicke-Korsakoff syndrome gets steadily worse, and can be life threatening. With treatment, it is possible to control symptoms (such as uncoordinated movement and vision difficulties ). This disorder can also be slowed or stopped.

 

Possible Complications

 

Complications that may result include:

  • Alcohol withdrawal
  • Difficulty with personal or social interaction
  • Injury caused by falls
  • Permanent alcoholic neuropathy
  • Permanent loss of thinking skills
  • Permanent loss of memory
  • Shortened life span

 

When to Contact a Medical Professional

 

Call your health care provider or go to the emergency room if you have symptoms of Wernicke-Korsakoff syndrome, or if you have been diagnosed with the condition and your symptoms get worse or return.

 

Prevention

 

Not drinking alcohol or drinking in moderation and getting enough nutrition reduce the risk of developing Wernicke-Korsakoff syndrome. If a heavy drinker will not quit, thiamine supplements and a good diet may reduce the chance of getting this condition, but the risk is not eliminated.

 

 

Open References

References

Koppel BS. Nutritional and alcohol-related neurologic disorders. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 416.

So YT. Deficiency diseases of the nervous system. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SK, eds. Bradley's Neurology in Clinical Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 85.

 
  • Central nervous system

    Central nervous system - illustration

    The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.

    Central nervous system

    illustration

    • Central nervous system

      Central nervous system - illustration

      The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.

      Central nervous system

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Wernicke-Korsakoff syndrome

           
             

            Review Date: 2/27/2016

            Reviewed By: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

             
             
             

             

             

            A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.



            Content is best viewed in IE9 or above, Firefox and Google Chrome browser.