Wernicke-Korsakoff Syndrome Symptoms, Causes & Treatment Options

Wernicke-Korsakoff syndrome is an irreversible disease that is a consequence of thiamine deficiency. This syndrome can cause changes to your vision, the way you walk or keep balance, and your mental status. [1]

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Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is Wernicke-Korsakoff Syndrome?

Summary

Wernicke-Korsakoff syndrome should be differentiated from Wernicke encephalopathy. Wernicke encephalopathy is also caused by thiamine deficiency; however, it is an acute, reversible disease that will cause changes to your vision, mental status, and gait. Wernicke-Korsakoff syndrome is a severe complication of Wernicke encephalopathy, in which you will continue to experience changes to your vision and gait, but you will also have problems with your memory and cognition. [2] Both Wernicke encephalopathy and Wernicke-Korsakoff syndrome are both caused by a lack of thiamine, a vital vitamin. Your doctor will diagnosis you with either of these conditions based on what symptoms you endorse and your physical exam findings. Unfortunately, it is very uncommon for individuals with Wernicke-Korsakoff syndrome to recover to their baseline. [1]

Recommended care

Wernicke-Korsakoff Syndrome Symptoms

Main symptoms

If you suffer from Wernicke-Korsakoff syndrome, your doctor will make the diagnosis by evaluating you for the following symptoms. [1]

Changes to your eye function

  • Double vision
  • Loss of your vision without pain
  • Displacement of your eye
  • Inability to align both of your eyes at the same time

Changes to the way you walk

  • Unsteadiness or inability to stand without assistance
  • Walking with a widened stance and short steps

Changes to your cognition

  • Confusion
  • Apathy or indifference to your environment
  • Problems remembering past memories
  • Problems creating new memories

As your disease progresses, you may also experience the following symptoms: [1]

Changes to your mental status

  • Increased anger or agitation
  • Visual hallucinations (i.e., thinking that you see something that is not actually there)
  • Confabulations (i.e., accidentally misrepresenting your memories)

Wernicke-Korsakoff Syndrome Causes

The cause of Wernicke-Korsakoff syndrome is a lack of thiamine which is also known as Vitamin B1. The lack of thiamine causes the cells in particular areas of your brain to die which leads to the symptoms described above. There are many reasons why individuals may lack adequate levels of thiamine which causes them to develop this disease. Causes of thiamine deficiency include but are not limited to alcohol abuse, severe malnutrition or starvation, terminal cancer, immunodeficiency syndromes, and hyperemesis gravidarum (i.e., significant vomiting during the first trimester of pregnancy). In individuals who consume high amounts of alcohol, there is likely impaired absorption of thiamine in the gut and decreased storage of thiamine in the liver. The number of individuals who suffer from Wernicke-Korsakoff syndrome is higher in developing countries due to malnutrition and vitamin deficiencies. [3]

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Treatment Options, Relief, and Prevention for Wernicke-Korsakoff Syndrome

Treatment

If you have symptoms that are described above or you notice a friend or family member that has these symptoms, you should bring yourself or your loved one to see a doctor right away. Wernicke encephalopathy can be treated; however, Wernicke-Korsakoff syndrome is not reversible because of the brain damage that has already occurred. Both individuals who suffer from Wernicke encephalopathy and Wernicke-Korsakoff will be treated with thiamine rapidly. Your doctor will additionally provide you with magnesium, vitamin B12, and folate. Additionally, you will receive supportive care including intravenous fluids and multivitamins.

It is very likely that if you come in to see a healthcare provider with signs of Wernicke encephalopathy or Wernicke-Korsakoff syndrome, you will be admitted to a hospital for further management of your disease. If you are a chronic alcohol drinker and are found to have low levels of thiamine, you should seek out resources to help you quit drinking alcohol. You should follow closely with your primary care doctor to ensure that your vitamin levels improve to avoid progression to Wernicke-Korsakoff syndrome. Most individuals who suffer from this syndrome will need long-term care in a facility. [1]

Prevention

Wernicke-Korsakoff syndrome is caused by low levels of thiamine, or vitamin B1. It is best prevented by managing the underlying cause that may precipitate lower levels of thiamine. As mentioned above, if you drink alcohol heavily, you are at risk for developing Wernicke-Korsakoff and should seek out resources to help you quit drinking. You should aim to eat a balanced, healthy diet daily to ensure adequate nutrition. If you have an underlying illness such as cancer, hyperemesis gravidarum, or an immunodeficiency syndrome, you should ask your doctor if you should take a thiamine supplement to prevent this disease. [1]

You should also look out for signs of Wernicke encephalopathy that is an acute, reversible process due to thiamine deficiency and a precursor to Wernicke-Korsakoff syndrome. Signs of Wernicke encephalopathy include changes to your vision, changes to the way that you walk, and changes to your mental status/cognition. If you notice any of these signs, you should see a doctor and you can start taking thiamine, folate, and a multivitamin over the counter in the meantime. [1]

When to Seek Further Consultation for Wernicke-Korsakoff Syndrome

If you have changes to your vision (e.g., double vision, painless loss of vision, shift in the orientation of your eyes), changes to your gait (e.g., widened stance, shortened steps), or changes to your mental status (e.g., difficulty remembering things, agitation, confabulation), you should see a doctor as soon as possible. Additionally, if you have been diagnosed with a disease (noted above) that increases your likelihood of developing a thiamine deficiency, you should ask your doctor about the need to take thiamine supplements.

If you drink alcohol heavily or have ever been hospitalized for alcohol intoxication, detoxification, or withdrawal, you should ask your doctor if you need to take thiamine daily. Furthermore, if you have ever experienced symptoms concerning for alcohol ingestion or withdrawal such as tremors, seizures, pancreatitis, or cirrhosis, you should seek further advice about vitamin supplementation. [1]