Wernicke Korsakoff

Wernicke-Korsakoff’s syndrome is actually a combination of two disorders caused by a deficiency of thiamine, or vitamin B1, an essential coenzyme.

Wernicke’s encephalopathy is caused by acute thiamine deficiency…which causes brain damage. The usual result is Korsakoff’s psychosis. Both of these diseases are typically seen in people who have suffered from alcohol use disorder, or alcoholism, which causes the thiamine deficiency.

Because of the connection between these two diseases, they’re often both present at the same time, and the diagnosis is WKS-a single syndrome. However, either of these conditions can be diagnosed separately.

Wernicke’s encephalopathy is identified by a three symptom cluster: tremor like and paralysis problems with the eyes, mental confusion, and unsteady gate.

It can affect one or both eyes, appears usually as a weakness in the muscles that move the eye, but on occasion, it can also affect the muscles that control dilation and constriction of the pupil, or as nystagmus, a rapid movement of the eye.

The changes in mental state occur in about 82% of cases and can range from apathy and confusion to loss of concentration and a decreasing awareness of the situation the person is in.

The unsteady gait is seen in only 23% of cases and is the outcome of abnormality found in the cerebellum and vestibular system. In addition, sometimes the individual also develops low blood pressure, stupor, elevated heart rate, progressive hearing loss, hypothermia, and epileptic seizures.

If the condition isn’t treated, Wernicke’s encephalopathy can lead to coma and even death. The obvious first treatment is an administration of thiamine or vitamin B1.

When acute and severe memory loss suddenly appears without a change in intellectual abilities, this is usually diagnosed as Korsakoff’s Syndrome.

The syndrome consists of these two primary symptoms; inability to remember new information (anterograde amnesia), and some variation of retrograde amnesia, which is an inability in remembering the recent past.

Plus, one of these symptoms: aphasia (an inability to comprehend or formulate language), apraxia (difficulty with motor planning to carry out a specific task…such as combing hair), agnosia (the inability to interpret information gathered by the five senses), or a deficit in executive function (cognitive control, stimulus control, reasoning, problem solving).

While some contend that WKS is caused by alcoholism, there are cases where no alcohol was involved. So it’s important to understand that it’s caused by B1 deficiency. Any situation that causes B1 and displays the symptoms we’ve talked about here, may be WKS.

An example is a WWII prisoner of war hospital in Singapore, where the prisoners were fed less than 1mg of B1 daily. These prisoners experienced insomnia, anxiety, confusion, degeneration of the mental state, and hallucinations.

The sooner these symptoms are recognized in an individual and emergency medical treatment is initiated, thiamine should be administered immediately. Early recognition of symptoms and prompt treatment can not only be life-saving but can prevent or slow brain damage.

Generally, when Wernicke encephalopathy is untreated, it eventually progresses to Korsakoff’s Syndrome.

If you have a loved one whose nutrition has been seriously compromised by alcohol use disorder or another circumstance or illness that prevents absorption of B1, seek medical attention.

Then, if the symptoms include problems with memory or cognition, call us. We can help you as you seek information for the decisions that lie ahead.

When someone you love is changing, it’s a helpless feeling. And you needn’t face it alone. Contact us here.