Wernicke-Korsakoff Syndrome

What Is Wernicke-Korsakoff Syndrome?

Wernicke-Korsakoff syndrome (WKS) is one name for two conditions that often happen together -- Wernicke encephalopathy and Korsakoff syndrome. Many doctors think of them as different stages of the same disease.

They can happen if you don’t get enough vitamin B1, also called thiamine. Vitamin B1 helps your brain turn sugar into energy. When your brain and nervous system don’t get the amount they need, they don’t work as well.

Wernicke encephalopathy typically comes on suddenly, and you’ll need treatment right away. Symptoms include confusion, loss of muscle coordination, and trouble with your vision. Korsakoff syndrome happens more slowly. It’s a long-term, ongoing problem that damages the part of your brain that handles memory.

Wernicke-Korsakoff Syndrome Symptoms

The main signs of Wernicke encephalopathy are:

• Balance and movement issues. You might have leg tremors, and your walk might become slow and unsteady, with a wide stance and short steps. You may need help standing and getting around, and your arms and legs might feel weak.
• Confusion. You may feel out of it and lose interest in what’s happening around you.
• Eye problems. You may have double vision, your eyelids might droop, or your eyes may move around quickly.

You also may have problems with your heart and blood vessels that can lead to:

• Drowsiness
• Fainting
• A faster heartbeat than normal
• Low blood pressure when you stand up
• A lack of energy

If you aren’t treated for Wernicke encephalopathy quickly, it can lead to Korsakoff syndrome.

Symptoms of Korsakoff syndrome usually begin as the signs of Wernicke encephalopathy start to go away. The telltale sign is the loss of short-term memory. That also makes it hard for you to learn anything new or make new memories.

You might talk to someone and seem like yourself. But a minute or two later, you won’t remember anything about it, not even who you spoke with.

You may also have:

• Some long-term memory loss
• The urge to make up stories without knowing it to fill in any gaps
• Hallucinations
• A hard time putting words into context
• Trouble understanding or processing information

Wernicke-Korsakoff Syndrome Causes and Risk Factors

In many cases, the lack of vitamin B1 is caused by heavy, long-term alcohol use. Over time, alcohol affects how well your body absorbs, stores, and uses it.

It also can happen if you don’t get enough nutrients from your diet or if you have certain health problems. These other causes include:

• Some diseases that affect your whole body, like cancer, AIDS, or serious infections
• Eating disorders, like anorexia
• Serious kidney problems
• Chemotherapy treatment for cancer
• Some stomach conditions
• Throwing up often and over a long period of time
• Weight loss surgery, also known as gastric bypass

Men get Wernicke-Korsakoff syndrome a little more often than women, and it typically happens in people ages 45-65. It's also more common in:

• People who are homeless
• Older adults living alone
• People with serious mental health conditions

These groups are more likely to abuse alcohol or not eat well.

Wernicke-Korsakoff Syndrome Diagnosis

Typically, it’s based on a physical exam, your health history, and some tests. Your doctor will also want to rule out other problems that could cause your symptoms.

You may get:

• Blood tests to see how much thiamine is in your system and how well your liver and kidneys are working
• Imaging scans of your brain to rule out problems like a tumor or stroke
• An eye exam to check your eye movement
• A mental health exam
• Tests to check your brain and nervous system
• Tests to look at changes in how you walk

Wernicke-Korsakoff Syndrome Treatment

The first step is to get plenty of vitamin B1. You’ll probably have it put directly into a vein through a needle in your hand or arm (an IV). You might need to have this every day for several months.

From there, it’s important to stay away from alcohol and eat a balanced diet. That’ll help keep symptoms from coming back.

If it affects how you walk, you’ll likely need physical therapy.

Wernicke-Korsakoff Syndrome Complications

Korsakoff syndrome typically can’t be reversed. In serious cases, it can cause brain damage and lead to problems with memory and your walk that don’t go away.

Wernicke-Korsakoff Syndrome Outlook

Your recovery will depend mostly on how early you started treatment.

If you catch and treat it early, you can make a full recovery, but it could take up to a year. Confusion and issues related to it are often the last symptoms to go away.

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