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  • Chronic alcohol misuse can have a damaging effect on the brain, including Wernicke-Korsakoff syndrome. This condition can suddenly and dramatically reduce an individual’s quality of life and life expectancy with no prior warning.

    Cause Of Wernicke-Korsakoff Syndrome

    Also known as alcoholic encephalopathy, alcohol dementia, Wernicke’s dementia, and Wernicke’s disease, Wernicke-Korsakoff syndrome is caused by brain damage resulting from a deficiency in vitamin B1, also called thiamine.

    Vitamin B1 is an essential nutrient used by animals to convert carbohydrates into glucose, which the body uses as fuel, among other uses.

    If the human body is denied the proper amount of vitamin B1, it will draw on reserves of the nutrient located in the liver until these are expended. At this point, brain damage may result as energy-hungry neurons (brain cells) are slowly starved, leading to necrosis (cell death).

    Thiamine Deficiency & AUDs

    There are several different effects of alcohol use disorders that contribute to Wernicke-Korsakoff syndrome, including:

    • individuals suffering from severe AUDs often neglect self-care and proper nutrition, leading to malnutrition and deficits in vitamin B1
    • alcohol causes nutrient malabsorption, as ethanol interferes with the absorption, storage, and processing of vitamin B1, the digestive system, and the liver
    • alcoholic liver disease and cirrhosis also damage the liver’s ability to store and process vitamin b1

    Accordingly, most cases of this disease in the United States can be traced to chronic alcohol abuse, though thiamine deficiency can also develop due to anorexia, cancer treatments, chronic illness, or weight-loss surgeries in some cases.

    Prevalence Of Wernicke-Korsakoff Syndrome

    Wernicke-Korsakoff Syndrome occurs in approximately 1-2% of the United States population and mainly impacts those between 55 and 65 years of age. The disease is diagnosed in men significantly more often than women.

    Symptoms Of Wernicke’s Encephalopathy

    Wernicke-Korsakoff syndrome involves two closely linked but distinct conditions: Wernicke’s encephalopathy and Korsakoff’s psychosis. 

    The first of these, Wernicke’s encephalopathy, involves the sudden development of three sets of symptoms:

    • ophthalmoplegia, vision, and eye changes that may include eyelid drooping, double vision, and nystagmus (unusual eye movements)
    • ataxia, disorientation with loss of control of bodily movements, balance, and muscle coordination
    • confusion and mental changes
    • other conditions including fatigue, hearing loss, apathy, and hypothermia have also be reported

    Because few individuals experiencing Wernicke’s encephalopathy display all three sets of symptoms at once, it can be difficult for healthcare providers or loved ones to consistently recognize and diagnose this condition when it develops.

    However, Wernicke’s encephalopathy should be considered a medical emergency. With prompt and proper treatment the condition is largely reversible.

    Symptoms Of Korsakoff’s Psychosis

    As more and more cells starve and die, damage mounts in the medial thalamus and mammillary bodies of the posterior hypothalamus, along with overall damage to the structure of the brain as a whole. 

    This then leads to severe issues in memory and mental state that are known as Korsakoff’s psychosis

    Symptoms of Korsakoff’s psychosis may include:

    • anterograde amnesia, or short-term memory loss
    • retrograde amnesia, or long-term memory loss
    • fixation amnesia, or loss of immediate memory
    • confabulation, a condition where individuals invent false memories and stories
    • changes in mental status including apathy and indifference
    • hallucinations, or seeing or hearing things that aren’t there

    Alternatively known as Korsakoff Syndrome, this severe brain disease develops in approximately 80-90% of cases as the symptoms of Wernicke’s encephalopathy fade. 

    Unfortunately, these symptoms are a result of damage and cell death in the brain tissue leading to impairment of brain functions, and they are not typically reversible.

    Treatment & Prognosis

    Whether or not treatment (in the form of large doses of vitamin B1) will be effective depends on how advanced the condition has come and how much damage has already occurred. 

    According to estimates, up to 25% of individuals may recover completely with proper treatment, 50% may improve, and 25% will remain the same. 

    If not diagnosed and effectively treated, up to 20% of those with Wernicke’s encephalopathy will not survive.

    Effective treatment for this condition necessarily involves permanent abstinence from alcohol, despite the potential difficulties of alcohol withdrawal.


    Once Wernicke-Korsakoff syndrome develops it only becomes more severe over time if left untreated, especially if heavy alcohol consumption continues. 

    Heavy drinkers and chronic alcoholics can mitigate their risk of developing Wernicke-Korsakoff Syndrome with proper diet and nutrition supplements, and all but eliminate the risk by abstaining from alcohol entirely.

    To learn about our alcohol use disorder treatment services, please connect with us today.

    Written by Ark Behavioral Health Editorial Team
    ©2023 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    Journal of Psychiatric and Mental Health Nursing - Health problems and care needs in patients with Korsakoff’s syndrome: A systematic review
    National Library of Medicine: MedlinePlus - Wernicke-Korsakoff Syndrome
    National Institute of Neurological Disorders and Stroke (NIH) - Wernicke-Korsakoff Syndrome Information Page

    Medically Reviewed by
    Manish Mishra, MBBS
    on June 30, 2022
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