Wernicke-Korsakoff Syndrome: Causes, Risk Factors, Symptoms, & Treatment

Last Updated: March 24, 2023

Editorial Policy | Research Policy

Learn about the permanent effects of Wernicke-Korsakoff syndrome and how alcohol addiction can lead to this type of brain damage.

Wernicke-Korsakoff syndrome1 is connected with alcohol use and can lead to death or permanent brain damage if not treated quickly. This disease is reversible in the earlier stage, but it eventually becomes permanent, creating a form of irreversible dementia. Wernicke-Korsakoff syndrome is caused by a deficiency in vitamin B1, or thiamine.

What Is Wernicke-Korsakoff Syndrome?

Wernicke-Korsakoff syndrome is a type of brain disorder that is caused by a lack of thiamine. This syndrome consists of two parts: Wernicke encephalopathy, also called Wernicke syndrome, and Korsakoff syndrome. These two conditions have different symptoms but are really two stages of the same disease2.

Wernicke Encephalopathy

Wernicke encephalopathy3 is the first stage of Wernicke-Korsakoff syndrome and causes inflammation of the brain. Wernicke encephalopathy is reversible if treated quickly and can prevent further progression of brain damage caused by the lack of thiamine. It is often described as the “acute” phase of Wernicke-Korsakoff syndrome. While Wernicke encephalopathy is a more temporary phase of the entire disease, it can be dangerous, resulting in death in 17%4 of people who are untreated.

Wernicke’s Encephalopathy Symptoms

Wernicke encephalopathy can cause many symptoms, but three core symptoms are referred5 to as a “triad” of symptoms that often occur in Wernicke encephalopathy. These include:

  • Mental changes, such as confusion
  • Decreased muscle coordination
  • Eye movement abnormalities

Other symptoms of Wernicke encephalopathy can include:

  • Lethargy
  • Decreased attention span
  • Lack of concern for life
  • Problems walking
  • Problems standing up
  • Coma

Korsakoff’s Syndrome

About 80%–90%1 of people who develop Wernicke encephalopathy will develop Korsakoff syndrome. This condition is an irreversible form of dementia and can cause short-term memory loss. This makes learning new information or retaining new information impossible.

Those with Korsakoff syndrome may also develop gaps in their long-term memory and subconsciously make up new memories to fill these gaps. Hallucination can also occur in those with Korsakoff syndrome.

Memory problems associated with Korsakoff syndrome do not impair the ability to have a normal conversation, and will only be noticeable in the inability to remember new information or recall old memories. Those with Korsakoff syndrome are often unaware they have it, as they do not notice the impairment and are not able to form the new memory needed to understand that they have this condition.

Wet Brain

“Wet brain”6 is a non-medical term used to refer to Wernicke-Korsakoff syndrome. Those who use the term “wet brain” sometimes wonder if there is a difference between Wernicke-Korsakoff syndrome and wet brain. Technically, there could be a small difference between the two terms.

Wernicke-Korsakoff syndrome describes the brain disease caused by a lack of thiamine. Wet brain describes brain damage caused by thiamine deficiency exclusively due to alcohol use. In most developed countries, the major cause of thiamine deficiency is alcohol use, making these two terms synonymous in the United States.

Causes and Risk Factors

The most common cause of Wernicke-Korsakoff syndrome is heavy alcohol use. Alcohol use causes poorer nutrition, decreases the absorption of thiamine, and depletes thiamine levels in the body. These effects all work together to cause a thiamine deficiency that can lead to Wernicke-Korsakoff syndrome.

While alcohol use is the main cause of Wernicke-Korsakoff syndrome, it can be caused by a lack of thiamine in food7. Food sources of thiamine are so abundant that this is only a problem for people who are facing starvation or those who have an eating disorder. Decreased thiamine levels are also possible in people with prolonged, heavy vomiting, which can be caused by chemotherapy or a complication of pregnancy called hyperemesis gravidarum.

Wernicke-Korsakoff Syndrome Symptoms

The symptoms of Wernicke-Korsakoff syndrome2 vary based on the stage of disease, but they include:

  • Vision problems
  • Difficulty moving eyes
  • Decreased coordination
  • Problems walking
  • Clumsiness
  • Fast heart rate
  • Low blood pressure
  • Decreased body temperature
  • Weakness
  • Memory problems
  • Hallucinations

Wernicke-Korsakoff Syndrome Life Expectancy

Wernicke-Korsakoff syndrome can lead to a severely decreased life expectancy, with about 50% of people dying within eight years of diagnosis8. This is partially due to the effects of Wernicke-Korsakoff syndrome rather than the disease itself. Severe alcoholism is often the cause of this disease and can decrease life expectancy, even without Wernicke-Korsakoff syndrome. Because alcoholism and Wernicke-Korsakoff syndrome are closely related, it is difficult to determine Wernicke-Korsakoff syndrome’s role in decreasing life expectancy.

Wernicke-Korsakoff Syndrome Treatment

Wernicke-Korsakoff syndrome treatment has two main components. Firstly, the thiamine deficiency causing the disease is reversed9 by providing thiamine. This is often done through an IV to reverse the deficiency quickly.

The second step in treating Wernicke-Korsakoff syndrome is to address the underlying cause of thiamine deficiency. In the United States, this most commonly involves stopping the use of alcohol. If alcohol use is severe enough to cause Wernicke-Korsakoff syndrome, it is normally associated with alcoholism that will require professional addiction treatment.

Alcohol Rehab in NJ

If you or someone you know is at risk of developing Wernicke-Korsakoff syndrome, the best way to avoid this permanent form of brain damage is to get help for their alcohol use disorder. An alcohol addiction this severe will normally require alcohol rehab for the person to recover successfully.

The Recovery Village Cherry Hill at Cooper has a proven record of helping people in New Jersey and beyond achieve lasting freedom from alcohol addiction. We invite you to contact us to learn more about how we can help you achieve lasting sobriety and avoid the dangers of Wernicke-Korsakoff syndrome.

Questions?

Our Recovery Advocates are ready to answer your questions about addiction treatment and help you start your recovery.

Call Now

Sources

  1. National Organization for Rare Disorders (NORD). “Wernicke-Korsakoff Syndrome.” 2021. Accessed January 20, 2022.
  2. Shelat, AM. “Wernicke-Korsakoff syndrome.” MedlinePlus. February 4, 2020. Accessed January 20, 2022.
  3. National Institute of Neurological Disorders and Stroke. “Wernicke-Korsakoff Syndrome Information Page.” March 27, 2019. Accessed January 20, 2022.
  4. Lindberg, MC; Oyler, RA. “Wernicke’s encephalopathy.” American Family Physician, April 1990. Accessed January 20, 2022.
  5. Feinberg, JF. “The Wernicke-Korsakoff syndrome.” American Family Physician, November 1980. Accessed January 20, 2022.
  6. Martin, PR; Singleton, CK; et al. “The Role of Thiamine Deficiency in Alcoholic Brain Disease.” Alcohol Research & Health, 2003. Accessed January 20, 2022.
  7. The President and Fellows of Harvard College. “Thiamin – Vitamin B1.” Harvard T. H. Chan School of Public Health, 2022. Accessed January 20, 2022.
  8. Sanvisena, A; Zuluaga, P; et al. “Long-Term Mortality of Patients with an […]e-Korsakoff Syndrome.” Alcohol and Alcoholism, July 2017. Accessed January 20, 2022.
  9. Xiong, GL. “Wernicke-Korsakoff Syndrome Treatment & Management.” Medscape, May 16, 2018. Accessed January 20, 2022.