What You Should Know About Wernicke-Korsakoff Syndrome
Wernicke-Korsakoff syndrome (wet brain syndrome) is actually two different syndromes involving a severe vitamin B1 (thiamine) deficiency. Wernicke encephalopathy affects the nervous system, while Korsakoff syndrome is considered a cognitive disorder. A combination of Wernicke encephalopathy and Korsakoff syndrome is diagnosed in alcoholics suffering a long-term vitamin B deficiency and alcohol-induced damage to their brain.
Thiamine (B1) and Alcoholism
Alcohol inhibits the absorption of thiamine in the intestines, the primary part of the body where nutrients enter the bloodstream. An essential nutrient, vitamin B1 must be obtained by eating food containing thiamine, such as poultry, peas, brown rice, whole grains and breads.
Thiamine is mostly found in the brain, kidneys, liver and heart, which explains why individuals with wet brain syndrome have a variety of serious medical issues. Heart and nervous system cells are extremely sensitive to a thiamine deficiency. Congestive heart failure and extensive cognitive impairment (“mush brain”) are often the cause of alcoholics requiring long-term hospitalization or nursing home care.
Symptoms of Wernicke Encephalopathy
Wet brain syndrome consists of the severe, short-lived Wernicke encephalopathy symptoms and the more debilitating, longer-lasting Korsakoff syndrome symptoms. Specifically caused by a thiamine deficiency, early signs of Wernicke encephalopathy include:
- Progressive loss of appetite/dramatic weight loss over one year
- Drowsiness, fatigue, lethargy
- Craving carbohydrates/eating nothing but sugary, high-fat foods
- Regularly vomiting for more than 30 days
- Anemia, dehydration and other medical problems due to malnutrition
- Worsening memory loss/difficulty thinking clearly
Later stage symptoms of Wernicke encephalopathy involve:
- Mental confusion/inability to comprehend conversations
- Ataxia (loss of muscle strength and coordination)
- Leg tremors
- Nystagmus (rapid back-and-forth movement of the eyes)
- Double vision
- Drooping eyelids
- Inability to walk
Most people with Wernicke encephalopathy experience progressive worsening of symptoms but do not die from the disease. They will need supportive care, however, in long-term care facilities designed to help people with severe dementia.
Symptoms of Korsakoff Syndrome
Nine out of 10 alcoholics (mostly men between 45 and 65 years of age) will eventually develop Korsakoff syndrome, a neuropsychiatric condition characterized by amnesia and behavioral abnormalities. Lack of vitamin B1 is the direct cause of Korsakoff syndrome, which contributes to cerebral atrophy and the following cognitive problems:
- Forgetting what they said or did an hour after saying or doing something. Learning and retaining new information is nearly impossible for people with Korsakoff syndrome
- Confabulating, or making up things they cannot remember but insist happened. Confabulating is not telling a lie. Korsakoff syndrome patients believe explanations their brains invent.
- Experiencing auditory or visual hallucinations that may persist or come and go randomly
Korsakoff syndrome should not be confused with Alzheimer’s disease. Although these two disorders share similarities involving memory and cognitive problems, people with early to moderate stage Korsakoff syndrome can still socialize and perform basic daily tasks. You may have a normal conversation with someone with Korsakoff syndrome, but that person will likely not remember the conversation just an hour or two afterward.
Recognizing Signs of Wernicke-Korsakoff Syndrome
In most cases, symptoms of Korsakoff syndrome are preceded by symptoms of Wernicke encephalopathy. When an alcoholic suffers an acute lack of vitamin B1 too rapidly, the onset of Wernicke encephalopathy may be severe enough to demand emergency medical attention. In addition to muscle weakness, extreme confusion and agitation, the person will likely require treatment for tachycardia (abnormally rapid heartbeat), postural hypotension (extremely low blood pressure when standing up from a sitting position) and possible loss of consciousness.
Do All Alcoholics Develop Wernicke-Korsakoff Syndrome?
If someone develops a drinking problem, seeks treatment within a few years of the onset of their alcoholism and remains sober, chances are they’re not a risk for Wernicke-Korsakoff syndrome. Chronic alcoholics, or those who consistently drink for many years and never enter alcohol rehab, are likely to suffer symptoms of Wernicke-Korsakoff syndrome.
Alcohol dementia can strike men and women as young as 30. However, it’s more commonly seen in older people.
In addition, the onset of Wernicke-Korsakoff syndrome and symptom severity is not directly related to the amount or type of alcohol a person drinks over their lifetime. Genetics, preexisting conditions and other factors help determine whether an alcoholic eventually develops this disease.
Although Wernicke-Korsakoff syndrome has a low prevalence of between 0.4% and nearly 3%, doctors think this disease is frequently misdiagnosed or underreported. Studies have found that about four out of every 100 cases of Wernicke-Korsakoff syndrome were missed because autopsies failed to microscopically examine the brain. Additional studies have discovered that between 22% and 29% of people diagnosed with general dementia were actually alcoholics.
What Is the Standard Treatment for Wernicke-Korsakoff Syndrome?
Improving symptoms and delaying the progression of this disease is the goal of treatment. Following a medical detoxification and complete physical and mental evaluation, people with wet brain disease receive intravenous administration of thiamine, magnesium or both. Within several weeks, most patients see an improvement in their physical and cognitive functioning. After being discharged from the hospital, patients should continue taking oral thiamine along with other vitamin supplements.
Currently, Wernicke-Korsakoff syndrome has no cure. Staying sober, eating healthy and receiving appropriate support for cognitive and physical needs is the best treatment for living with this disease.
Living with Wernicke-Korsakoff Syndrome
Depending on how severely someone is affected by Wernicke-Korsakoff syndrome, they may be able to live independently with assistance from caregivers or home health aides. They would also benefit from receiving outpatient treatment involving individual and group counseling services, life skills training and learning relapse prevention techniques from addiction counselors.
When a person is in the final stages of wet brain, they will likely need 24/7 nursing care. Alcohol is a neurotoxin that shrinks the brain (cerebral atrophy) and slowly destroys the frontal lobe, cerebellum and limbic system. In many ways, end-stage alcohol dementia resembles end-stage Alzheimer’s disease and requires the same level of intensive medical support.
Seeking Help for Wernicke-Korsakoff Syndrome
Call FHE Health today at (844) 299-0618 for more information about Wernicke-Korsakoff syndrome and our alcohol abuse treatment programs. Our team of caring counselors is waiting to receive your call any time of day or night.