Wernicke–Korsakoff syndrome and alcohol

Korsakoff syndrome is a chronic memory disease caused by thiamine deficiency (vitamin B-1). Korsakoff syndrome is most usually caused by alcohol abuse, however, it can also be caused by other disorders.

Wernicke–Korsakoff syndrome is a disorder that is akin to dementia and is caused by excessive alcohol use.

Wernicke–Korsakoff syndrome can be triggered by sources other than alcohol in rare cases. The majority of instances are caused by alcohol.

About Wernicke–Korsakoff syndrome

Thiamine aids brain cells in the production of energy from sugar. When levels drop too low, brain cells are unable to create enough energy to operate normally. Korsakoff syndrome is most usually caused by excessive alcohol consumption, although it can also be caused by AIDS, malignancies that have spread throughout the body, persistent infections, poor nutrition, and other disorders. It is also frequent in persons whose systems do not adequately digest meals (malabsorption). This might happen as a result of a chronic disease or after weight-loss (bariatric) surgery.

However, up to 80% of alcoholics have a thiamine deficiency, and some of these persons will go on to develop significant brain abnormalities such as Wernicke–Korsakoff syndrome (WKS). WKS is a sickness that comprises two distinct syndromes: Wernicke’s encephalopathy, a short–term, and severe disorder, and Korsakoff’s psychosis, a long–term and devastating condition.

Mental confusion, paralysis of the nerves that move the eyes (i.e., oculomotor abnormalities), and problems with muscular coordination are all indications of Wernicke’s encephalopathy.

Patients with Wernicke’s encephalopathy, for example, maybe:

  • too disoriented to find their way out of a room
  • maybe unable to move at all.
  • having difficulty controlling eye movements
  • being undernourished – for example, being very underweight or having lost a lot of weight in the previous months.

However, many Wernicke’s encephalopathy patients do not display all three of these signs and symptoms, and physicians working with alcoholics must be aware that this illness may be present even if the patient only exhibits one or two of them.

Indeed, postmortem investigations show that many cases of thiamine deficiency–related encephalopathy may go undiagnosed because not all of the “classic” signs and symptoms were present or recognized.

Korsakoff’s psychosis, a chronic and severe disease marked by persistent learning and memory impairments, affects around 80 to 90 percent of alcoholics with Wernicke’s encephalopathy. Korsakoff’s psychosis patients are forgetful, often irritated, and have difficulties walking and coordinating.

Although these individuals have difficulties recalling past knowledge (i.e., retrograde amnesia), it is their inability to “laid down” new information (i.e., anterograde amnesia) that is most noticeable. For example, some individuals may be able to explain an incident in their lives in great detail, but an hour later may not recall having had the conversation.

Wernicke–Korsakoff Diagnosis

Korsakoff syndrome is a clinical diagnosis that represents a physician’s best guess as to what is causing a person’s symptoms. There are no particular laboratory tests or neuroimaging methods that may be used to confirm a person’s diagnosis of this illness.

The syndrome might be difficult to recognize at times because it can be camouflaged by symptoms of other illnesses prevalent among persons who abuse alcohol, such as intoxication or withdrawal, infection, or brain injury.

According to experts, queries concerning an individual’s alcohol consumption should always be included in a medical workup for memory loss or other cognitive problems. Anyone hospitalized to the hospital for an alcohol-related ailment should undergo a professional memory and cognitive change screening.

Supplemental questions to test recent memory should be included in the screening. If the test results in a finding of impairment, the individual should be given a more thorough cognitive workup.

Wernicke–Korsakoff Treatment

The cerebellum, a region of the brain involved for coordinating movement and maybe even some types of learning, appears to be most vulnerable to the effects of thiamine deficiency and is the region most commonly injured in relation to chronic alcohol drinking. Thiamine supplementation improves brain function, particularly in individuals in the early stages of WKS.

When a brain injury is serious, the focus of care switches from therapy to support for the patient and his or her family. Custodial care may be required for the 25% of patients who have a persistent brain injury and considerable cognitive loss.

Scientists believe that a genetic variation may be one explanation for why only some alcoholics with thiamine deficiency develop severe conditions such as WKS, but more research is needed to determine how genetic variants may cause some people to be more vulnerable to WKS than others.

Abstinence from alcohol and adherence to a balanced diet are essential components of effective long-term therapy. Those suffering from Korsakoff syndrome have a lower tolerance for alcohol and may be at a higher risk of developing further alcohol-related health issues.