Wernicke-Korsakoff Syndrome | Causes, Symptoms, & Treatment

Wernicke-Korsakoff syndrome (WKS) is a type of degenerative neurological disorder caused by a lack of vitamin B or thiamine.

Some experts believe that the two conditions are actually two stages of the same disease. Wernicke’s encephalopathy is the first stage of the disorder and if left untreated, it develops into Korsakoff’s psychosis.

WKS is associated with chronic excessive alcohol consumption but can also occur in people with malnutrition and eating disorders. It can create coordination issues and memory impairment.

Causes Of Wernicke-Korsakoff Syndrome (WKS)

Wernicke-Korsakoff syndrome has a few different causes. Some have to do with alcohol while others do not.

Deficiency Of Thiamine/Vitamin B1

WKS is primarily caused by a deficiency of thiamine (vitamin B1). Thiamine is an important nutrient needed to metabolize glucose which is used as energy for the nervous system.

The lack of thiamine can affect the function of the brain including the thalamus and hypothalamus that control your temperature, appetite, emotions, and growth.

Chronic Alcohol Use

Chronic alcohol consumption can also lead to WKS. This occurs because alcohol reduces the absorption of thiamine into the body. Alcohol causes inflammation in the digestive tract which can make absorption more difficult.

Additionally, people who drink a lot of alcohol tend to not have the most balanced diet and don’t get enough thiamine from the food they eat. These low levels can lead to WKS.

Malnutrition

WKS can also be caused by malnutrition. Malnutrition can occur due to starvation, eating disorders (like anorexia nervosa), or chronic vomiting. Malnutrition can then lead to a lack of thiamine/vitamin B and bring on WKS.

Some chronic disorders can also cause WKS including cancer, AIDS, and stomach and kidney disorders.

Symptoms Of Wernicke-Korsakoff Syndrome

Wernicke-Korsakoff syndrome comes with a number of symptoms that range from mild to even life-threatening if left untreated. The symptoms include:

• memory loss
• tremors
• coma
• disorientation
• impairment in acquiring new information or keeping new memories
• mental confusion
• hypothermia
• low blood pressure
• lack of muscle coordination
• lethargy
• inattentiveness
• delirium
• difficulty walking (ataxia)
• rapid heartbeat
• hypothermia
• weakness in the limbs
• involuntary rapid eye movement (nystagmus)
• double vision
• urge to make up stories to fill in memory gaps (confabulation)
• drooping upper eyelid
• hallucinations

Risk Factors Of Wernicke-Korsakoff Syndrome

While anyone with a thiamine deficiency can develop WKS, some risk factors make it more likely in some people over others. These risk factors include:

• malnourishment: those who are malnourished are likely not getting enough thiamine
• history of alcohol abuse: heavy drinking can lead to a lack of thiamine absorption
• kidney dialysis: reduces vitamin B absorption
• AIDS: high risk of thiamine deficiency
• gastric cancer: can limit the absorption of essential nutrients like vitamin B
• eating disorders: those with eating disorders may not be getting enough vitamin B in their diet
• gender: men get the brain disorder a little more often than women
• age: people ages 45-65 have a higher prevalence for WKS

Treatment For Wernicke-Korsakoff Syndrome

The treatment for Wernicke-Korsakoff syndrome mainly includes getting more thiamine into your system and changing your diet/alcohol consumption to ensure it can be absorbed. The most common treatments include:

Replacement Therapy

The immediate treatment for WKS is replacement therapy or injecting thiamine into the body. It’s given through an IV because absorption through the abdomen can be difficult for people with this syndrome.

Once the thiamine is administered, the mental, physical, and visual issues that come with WKS improve almost immediately. Thiamine may need to be given for several months before the disorder is completely gone.

Proper Diet

Starting a balanced diet can increase how much thiamine you’re getting, but it can also ensure the symptoms of WKS never come back. Fish, beans, lentils, yogurt, and green peas are just a few foods that are rich in thiamine.

Physical Therapy

Because of the symptoms dealing with coordination and walking, some physical therapy might be needed as part of treatment for WKS. With this treatment, you may re-learn how to walk, how to use your muscles, and regain some of the strength you lost in your limbs.

Alcohol Abstinence

Quitting alcohol can also help treat WKS. It can ease some of the symptoms and prevent further brain damage. Without the alcohol, your body can start absorbing thiamine from food once again. A vitamin B or thiamine supplement may also be recommended.

If you’ve built up a tolerance to alcohol, a detox program may also be needed. When a tolerance to alcohol is built up, quitting it all of sudden can lead to severe withdrawal symptoms. A detox program ensures you’re in a safe and medically-supervised environment.

Once in detox, healthcare providers there will treat your alcohol withdrawal symptoms as they occur.

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