Wernicke-Korsakoff Syndrome

Wernicke–Korsakoff syndrome (WKS) is a brain disorder that impairs a person's thinking, eye movements, and balance and then causes long-term memory loss. The term actually describes two phases of the same condition.

Wernicke encephalopathy happens first. If the disease gets worse, Wernicke encephalopathy is followed by Korsakoff syndrome (Korsakoff psychosis). It is caused by not getting enough vitamin B₁ (thiamine). This condition can permanently damage the areas of the brain that are responsible for memory. Wernicke encephalopathy is a medical emergency.

What are the causes?

This condition is caused by a lack of thiamine in the body. This deficiency can result from:

Alcoholism. This is the most common cause.
Poor nutrition.
Certain medical conditions.
Bariatric or gastrointestinal surgery.

What increases the risk?

The following factors may make you more likely to develop this condition:

Having severe alcoholism.
Poor nutrition.
AIDS (acquired immunodeficiency syndrome).
Long-term (chronic) infections.
Failing to eat properly because of fear of weight gain (anorexia nervosa).
Kidney dialysis.
Advanced cancer.

What are the signs or symptoms?

Symptoms of this condition may vary based on the stage of the disease.

Symptoms of Wernicke encephalopathy include:

Uncoordinated muscles.
Abnormal eye movements.
Confusion.
Loss of other mental abilities.
Double vision.
Symptoms of alcohol withdrawal.

As the disease gets worse, symptoms of Korsakoff syndrome may develop. These include:

Severe memory loss.
Inability to form new memories.
Seeing, hearing, tasting, smelling, or feeling things that are not real (hallucinations).
Tendency to make up stories.

How is this diagnosed?

This condition may be diagnosed based on:

Your symptoms and medical history. Your health care provider may suspect this condition if you abuse alcohol.
A physical exam.
Blood tests to check your thiamine level and to look for other signs of malnutrition.
Tests to check for memory loss.
Imaging studies to look for changes in the brain and other body parts. These may include MRI and CT scans.

How is this treated?

This condition may be treated with:

Thiamine replacement therapy. You may be given thiamine through an IV or by mouth.
Treatment for alcoholism.
Treatment for other nutritional problems.
Medicine and mental health counseling for chronic dementia if appropriate.

Treatment for this condition needs to start early. If the condition is diagnosed and treated in the early stages, it can be reversed. If the condition is left untreated, it can cause permanent brain damage.

Follow these instructions at home:

Take over-the-counter and prescription medicines only as told by your health care provider.
Do not drink alcohol. Get treatment for alcoholism if needed.
Eat a nutritious, well-balanced diet.
- Be sure to include plenty of vegetables, fruits, low-fat dairy products, and lean protein.
- Limit foods that are high in solid fats, added sugars, or salt.
Get regular exercise.
- Most adults should exercise for at least 150 minutes each week. The exercise should increase your heart rate and make you sweat (moderate-intensity exercise).
- Most adults should also do strengthening exercises at least twice a week. This is in addition to the moderate-intensity exercise.
Get caregiver support if needed.
Keep all follow-up visits. This is important. Visits may include sessions for mental health counseling or meeting with a nutrition specialist (dietitian).

Where to find more information

National Institute of Neurological Disorders and Stroke: ninds.nih.gov

National Organization for Rare Disorders: rarediseases.org

Contact a health care provider if:

You have confusion or memory problems.
You have severe alcoholism.

Get help right away if:

Your symptoms become severe.
You have serious thoughts about hurting yourself or others.

If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. Go to your nearest emergency department or:

Call your local emergency services (911 in the U.S.).
Call a suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255 or 988 in the U.S. This is open 24 hours a day in the U.S.
Text the Crisis Text Line at 741741 (in the U.S.).

Summary

Wernicke–Korsakoff syndrome (WKS) is a brain disorder that impairs a person's thinking, eye movements, and balance and then causes long-term memory loss.
This condition is caused by a lack of vitamin B₁ (thiamine). That may be the result of alcoholism, poor eating habits, or certain medical conditions.
Treatment for WKS needs to start early. If the condition is diagnosed and treated in its early stages, it can be reversed. If the condition is left untreated, it can cause permanent brain damage.
Keep all follow-up visits.