Is Wernicke–Korsakoff Syndrome?
Wernicke-Korsakoff syndrome (WKS) is a type of brain disorder
caused by a lack of vitamin B-1. The syndrome is actually two separate
conditions that can occur at the same time. Usually, people get the symptoms of
Wernicke’s encephalopathy first.
Also called Wernicke’s disease, people with Wernicke’s
encephalopathy have bleeding in the lower sections of the brain, including the
thalamus and hypothalamus. These areas of the brain control the nervous and
endocrine systems. The bleeding causes brain damage that presents symptoms
involving your vision, coordination, and balance.
The signs of Korsakoff psychosis tend to follow as the Wernicke’s
symptoms decrease. If Wernicke’s disease is treated quickly and effectively,
Korsakoff syndrome may not develop. Korsakoff psychosis is the result of
chronic brain damage. Korsakoff syndrome affects the areas of your brain that
Alcoholism, or chronic alcohol abuse, is the
most common cause of WKS. WKS can also be linked to diet deficiencies or
other medical conditions that impair vitamin B-1 absorption. Vitamin B-1 is
also called thiamine.
To diagnose WKS, your doctor will look for clinical signs that
point to a vitamin B-1 deficiency. This can include blood tests that measure
thiamine levels and your general nutritional health, as well as tests to check
your liver function.
Chronic alcoholism can damage your liver, elevating your liver
enzymes. Diagnosis includes a physical examination to assess your:
- heart rate
- eye movements
- blood pressure
- body temperature
After diagnosis, your doctor will most likely give you vitamin B-1
intravenously, or through your vein. Fast treatment may reverse many of the
neurological symptoms of WKS.
The key to recovery is maintaining adequate vitamin B-1 levels,
which means refraining from alcohol abuse if you have WKS. You should also eat
a balanced diet.
Factors for WKS
Risk factors for WKS are related to your diet and lifestyle.
The major risk factors for developing WKS are malnourishment and
chronic alcoholism. Other risk factors for WKS include:
- being unable to afford medical care and proper
- undergoing kidney dialysis, which reduces
vitamin B-1 absorption
- AIDS, which makes you more likely to develop
conditions that lead to vitamin B-1 deficiency
The number one cause of WKS is alcoholism.
The less common causes of WKS are conditions that limit
nutritional absorption. Eating and nutrient absorption can be restricted by:
- gastric bypass surgery, which makes it difficult
to meet nutritional needs due to limited food portions
- colon cancer, which can cause pain that causes you
to put off eating
- eating disorders
Alcoholism is the number one cause of WKS because people who are alcoholics
generally have a poor diet. Alcohol also prevents vitamin B-1 absorption and
Lesions on the brain cause Wernicke’s disease (WD). These lesions
are the result of a vitamin B-1 deficiency.
Prominent symptoms of WD are:
- double vision
- a drooping upper eyelid
- up-and-down or side-to-side eye movements
- loss of muscle coordination
- a confused mental state
WD can later develop into Korsakoff’s syndrome. People who have
WKS have a variety of issues relating to memory. You may suffer from memory
loss or be unable to form new memories.
You may also have the following symptoms if you have WKS:
- amnesia for events that happen after the onset
of the disorder
- difficulty understanding the meaning of
- difficulty putting words into context
- exaggerated storytelling, or confabulation
Diagnosing WKS isn’t always easy.
An individual with WKS is often mentally confused. This can make
communication with the doctor difficult. Your doctor may overlook the
possibility of a physical disorder if you’re confused.
Your doctor may first check for signs of alcoholism. They may
check your blood alcohol levels. Sometimes, a doctor will take a liver function
test to check for liver damage. Liver damage is a common sign of alcoholism.
Your doctor may also order nutritional tests to make sure you
aren’t malnourished. Nutritional tests may include the following:
- A serum albumin test measures the levels of
albumin, which is a protein in the blood. Low levels of albumin may signal
nutritional deficiencies as well as kidney or liver problems.
- A serum vitamin B-1 test is a blood test to
check vitamin B-1 levels in the blood. Enzyme activity in the red blood cells
can be tested. Low enzyme activity in the red blood cells signals a vitamin B-1
You may also need imaging tests. These tests can help your doctor
find any damage that’s characteristic of WKS.
Diagnostic imaging tests for WKS include:
- an electrocardiogram (EKG) before and after
giving vitamin B-1, which can help your doctor find abnormalities
- a CT scan to check for brain lesions related to
- an MRI scan to look for brain changes related to
Your doctor may also use neuropsychological test to determine the
severity of any mental deficiencies.
WKS treatment should begin immediately. Prompt treatment may
delay or stop disease progression. Treatments are also able to reverse
non-permanent brain abnormalities.
Treatment may first involve hospitalization. At the hospital, you’ll
be monitored to ensure your digestive system is absorbing food properly.
The treatment for WKS may include:
- vitamin B-1 given through an IV in the arm or
- vitamin B-1 given by mouth
- a balanced diet to keep vitamin B-1 levels up
- treatment for alcoholism
In a small number of cases, treatment of vitamin B-1 deficiency
produces a negative reaction. This is more common in alcoholics.
Negative reactions to receiving vitamin B-1 may vary. Reactions
may include alcohol withdrawal symptoms like insomnia, sweating, or mood
swings. You may also experience hallucinations, confusion, or agitation.
The outlook for WKS is based on how far the disease has advanced.
Receiving early treatment before irreversible damage has occurred
dramatically improves your outlook.
Mortality rates are high if WKS is left untreated. Most deaths
are the result of a lung infection, blood poisoning (septicemia), or
irreversible brain damage.
Those who receive fast treatment can see progress in:
- eye problems
- muscle coordination
You must abstain from alcohol to continue recovery of memory and
You also need to eat a balanced diet to prevent future vitamin B-1
deficiencies. Foods rich in vitamin B-1 include:
- lean pork
- whole wheat bread
You can prevent WKS by avoiding alcohol and eating a balanced
diet rich in vitamin B-1.