South Mountain Memory Care, located just outside of Allentown, PA, in the Lehigh Valley, is committed to providing individualized, compassionate care to support our residents in achieving a well-balanced lifestyle. As memory care experts, we keep up with the latest developments in dementia care and research, and endeavor to share relevant information with our community.
Most people are vaguely aware of Alzheimer’s and some other dementias, but few may know about Wernicke-Korsakoff (WK) syndrome.
Wernicke-Korsakoff (WK) syndrome is a serious brain condition that is usually, but not exclusively, associated with chronic alcohol misuse and severe alcohol use disorder (AUD). Researchers estimate that it may remain undiagnosed in approximately 80 percent of patients.
What Causes WK Syndrome?
WK syndrome involves two different brain disorders that often occur together: Wernicke’s disease and Korsakoff’s psychosis. They result from brain damage associated with AUD, combined with vitamin B1 (thiamine) deficiency. In people with severe AUD, poor nutrition decreases the ability of the gut to absorb thiamine from food, increasing the chance of developing WK syndrome. Without treatment, WK syndrome can be disabling, produce permanent memory loss, and be life-threatening.
What Are the Symptoms of WK Syndrome?
In WK syndrome, damage occurs in a variety of brain regions, most notably the thalamus, hippocampus, hypothalamus, and cerebellum. These areas contribute to a wide range of functions such as vision, movement, language, sleep, memory, and motivation.
Symptoms of Wernicke’s disease include:
- confusion.
- lack of energy, hypothermia, low blood pressure, or coma.
- lack of muscle coordination that can affect posture and balance, and can lead to tremors (involuntary movements in one or more parts of the body).
- vision problems, such as abnormal eye movements (back-and-forth movements called nystagmus), double vision, misaligned or crossed eyes, and eyelid drooping.
Although some symptoms of Wernicke’s disease, such as muscle and vision problems, are reversible with prompt thiamine treatment, other symptoms may respond more slowly or may not be completely reversible. Without prompt treatment, Wernicke’s disease can progress to Korsakoff’s psychosis, which is not reversible.
Symptoms of Korsakoff’s psychosis include those listed above, as well as:
- potentially severe, irreversible memory impairments, including problems forming new memories and recalling memories.
- making up inaccurate stories about events or remembering events incorrectly.
- experiencing hallucinations (seeing or hearing things that are not there).
- repetitious speech and actions.
- problems with decision making, as well as planning, organizing, and completing tasks.
- lack of motivation and emotional apathy.
How Is WK Syndrome Diagnosed?
WK syndrome is clinically diagnosed based on a patient’s history and the presence of the above-mentioned symptoms. When clinicians identify possible cases of WK syndrome, they may be able to confirm the diagnosis through magnetic resonance imaging (MRI) scans of the brain. WK syndrome may result from other conditions that involve malnutrition and B1 deficiency, such as cancer, AIDS, excessive vomiting (often associated with pregnancy), anorexia nervosa, hemodialysis, and gastrointestinal or bariatric surgery. However, these cases are far less prevalent than cases associated with severe AUD.
How Is WK Syndrome Treated?
If you are concerned about someone with WK syndrome, talk to your primary care physician or a specialist, such as an internist, psychiatrist, addiction psychiatrist, addiction medicine physician, or neurologist.
Early symptoms of Wernicke’s disease can be reversed if detected and treated promptly and completely; therefore, Wernicke’s disease should be considered a medical emergency. Doctors treat Wernicke’s disease with intravenous administration of vitamin B1 and glucose. Treatment may also consist of addressing co-occurring symptoms in the short term.
Without adequate treatment, Wernicke’s disease can progress into Korsakoff’s psychosis. In Korsakoff’s psychosis, severe memory loss and other damage could become permanent. Treatments for Korsakoff’s psychosis include intravenous vitamin B1 replacement therapy and oral supplements for several weeks, as well as proper nutrition, hydration, and other medications to manage specific symptoms. Aside from B1 therapy in the short term, there is no one optimal treatment; treatment often varies depending on symptoms, severity, and other co-occurring deficits such as psychosis or other major psychiatric disorders. Memory rehabilitation therapies—similar to those provided for various forms of dementia—can be effective in lessening the symptoms, but severe cases often require residential care.
Caution: Alcohol Withdrawal
Abstaining from alcohol use is critical to prevent and reduce additional brain damage at all stages of WK syndrome. Please note that when someone who has been drinking heavily for a prolonged time suddenly stops drinking, the body can go into a painful or even potentially life-threatening process of withdrawal. Individuals should seek medical help to plan a safe recovery.
For more information about how alcohol affects the brain, please visit Alcohol and the Brain. For more information about available evidence-based treatments for AUD, please visit the NIAAA Alcohol Treatment Navigator.
Whatever the cause or level of your or your loved one’s memory issues, South Mountain Memory Care, with our unique culture, “small house” model, and abundance of certified caregivers, offers you the peace of mind of knowing your loved one will be cared for as if they were our family—which they are!
South Mountain Memory Care is committed to providing individualized, compassionate care to support our residents in achieving a well-balanced lifestyle. We strive to allow our residents to remain independent while emphasizing safety. Our focus is to enrich their life—mind, body, and spirit—by bringing new initiatives into their day-to-day regimen while maintaining the activities they find comfort in. South Mountain Memory Care offers the peace of mind you deserve. When it comes to those you care so deeply about, we understand because we care, too.
Adapted from: niaaa.nih.gov/publications/brochures-and-fact-sheets/wernicke-korsakoff-syndrome