Wernicke-Korsakoff syndrome Health Article

Definition

Wernicke-Korsakoff syndrome is a brain disorder due to thiamine deficiency.

Alternative Names

Korsakoff psychosis; Alcoholic encephalopathy; Encephalopathy - alcoholic; Wernicke's disease

Causes, incidence, and risk factors

Wernicke's encephalopathy and Korsakoff syndrome are believed to be two stages of the same condition.

Wernicke's encephalopathy is caused by damaging changes in the brain, usually due to a lack of vitamin B1 (thiamine).

A lack of vitamin B1 is common in people with alcoholism. Heavy alcohol use affects the breakdown of thiamine in the body. Even if someone who drinks alcohol heavily follows a well-balanced diet, most of the thiamine is not absorbed.

Korsakoff syndrome, or Korsakoff psychosis, tends to develop as Wernicke's symptoms go away. Korsakoff psychosis involves damage to areas of the brain involved with memory.

Symptoms

• Inability to form new memories
• Loss of memory, can be severe
• Loss of muscle coordination (ataxia)
  • Unsteady, uncoordinated walking
• Making up stories (confabulation)
• Seeing or hearing things that aren't really there (hallucinations)
• Vision changes
  • Abnormal eye movements
  • Double vision
  • Eyelid drooping

Note: There may also be symptoms of alcohol withdrawal.

Signs and tests

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

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

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

• Pyruvate
• Serum B1 levels
• Transketolase activity

Blood or urine alcohol levels and liver enzymes may be high in people with a history of long-term alcohol abuse.

Other conditions that may cause thiamine deficiency include:

• 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 in rare cases shows changes in the tissue of the brain.