Wernicke-Korsakoff syndrome

What is Wenicke-Korsakoff syndrome?

Wernicke-Korsakoff syndrome causes a loss of specific brain functions due to a lack of vitamin B1, or thiamine, which is an essential vitamin involved in helping the body make energy from carbohydrates. It also helps the heart, nervous system and muscles to function properly. It's found in pasta, whole grains, lean meats, fish, fortified cereals, peas, dried beans and soya beans.

Thiamine deficiency is also known as beriberi.

Symptoms

The initial physical symptoms due to brain damage are known as Wernickes encephalopathy and include abnormal gait and eye movements, which if untreated leads to the psychiatric disorder known as Korsakoff syndrome including dementia and psychosis.

People with Wernicke-Korsakoff syndrome are often mistakenly thought to be drunk, as there may be symptoms of uncoordinated walking and confusion. Other symptoms include disturbed vision and hallucinations.

People with the condition may also appear malnourished and may try to hide their memory loss by confabulating.

If alcohol misuse is the cause, symptoms associated with alcohol withdrawal, such as sweating and tremors, may also be present.

Complications include permanent loss of memory, permanent loss of cognitive skills, and difficulties with social and personal interaction. Careers, relationships and social lives are often severely affected.

Causes and risk factors

The main cause of Wernicke-Korsakoff syndrome is long-term alcohol misuse, which can lead to poor absorption and storage of thiamine.

This vitamin deficiency can also arise as a consequence of severe malnutrition or starvation, prolonged vomiting and eating disorders.

Wernicke-Korsakoff syndrome is most common in people aged over 45 and affects more men than women.

As with many health problems, following a healthy lifestyle that includes drinking alcohol only within safe recommended amounts (up to three to four units a day for men, and two to three units a day for women) and eating a healthy, balanced diet means alcohol-related and vitamin B1 deficiency-related health problems, such as Wernicke-Korsakoff syndrome, can be avoided.

Less commonly the syndrome is not due to alcohol abuse but follows nutritional stress such as rapid weight loss, bowel obstruction, thyrotoxicosis, cancer or renal dialysis.

Treatment and recovery

Once the syndrome's diagnosed, hospital admission is required to control symptoms. Thiamine replacement may improve symptoms of confusion, difficulties with vision and eye movement, and lack of coordination. It doesn't generally improve loss of memory and intellect.

Further treatment aims to control symptoms and prevent the disorder progressing. An important part of this is total abstinence from alcohol and eating a healthy diet.

If untreated, Wernicke-Korsakoff syndrome leads to death.