Chronic alcohol abuse destroys a person’s body, but perhaps one of the most devastating effects of alcohol abuse is Wernicke-Korsakoff Syndrome. Also known as “wet brain,” Wernicke-Korsakoff Syndrome is a severe mental disorder that occurs when malnutrition creates a thiamin deficiency. It is the ultimate and tragic consequence of years of heavy drinking. If caught in the early stages, Wernicke-Korsakoff Syndrome can be partially reversed through thiamin treatment. Late-stage Wernicke-Korsakoff Syndrome, however, has no effective treatment.
What is Wernicke-Korsakoff Syndrome?
Wernicke-Korsakoff Syndrome is a combination of two disorders: Wernicke’s encephalopathy and Korsakoff syndrome. Both disorders are believed to be two stages of the same condition, the acute phase being Wernicke’s encephalopathy and Korsakoff syndrome representing the chronic phase of the overall disease process. This is why Wernicke’s encephalopathy usually occurs first in patients.
Wernicke’s encephalopathy is caused when poor nutrition, specifically low thiamin levels, damages the brain. A lack of thiamin, or vitamin B1, is common among alcoholics and can occur through liver damage (which affects thiamin processing), intestinal damage (which inhibits nutrient absorption) and poor eating habits (liquid meals). Heavy drinking inhibits the body from breaking down thiamin to the point that thiamin can’t be absorbed, even if a person eats a well-balanced diet.
The brain needs fuel to function, and it runs on forms of natural sugar. Thiamine, helps brain cells turn sugar into energy. When levels of thiamine fall, the brain runs out of energy since brain cells cannot generate sufficient energy to continue in their proper functions. Over time, this can trigger Korsakoff syndrome to develop.
Some characteristics of Wernicke’s encephalopathy include abnormal stance and gait, or ataxia; confusion; and abnormal eye movements, also called nystagmus.
Korsakoff syndrome is a type of psychosis that develops as Wernicke’s symptoms subside. It occurs when areas of the brain are so damaged from thiamin deficiency that memory, problem-solving skills and learning abilities are affected. This end stage of the disease occurs in a small number of patients.
Although Korsakoff’s syndrome can be easy to confuse with more standard forms of dementia, it is actually different in several ways. First, Korsakoff’s syndrome dementia involves not just the brain and the central nervous system, but also the cardiovascular and peripheral nervous systems. It is also characterized not just by memory loss, but also by confabulation specifically; this means sufferers tend to fill in gaps in their memory with whatever information they can recall easily.
Symptoms of Wernicke-Korsakoff Syndrome
People with Wernicke-Korsakoff Syndrome will appear fairly normal at first: they are able to carry on conversations normally, have average intellect, and are able to recognize family members and old friends they met before the onset of the illness. After the onset of Wernicke-Korsakoff Syndrome, however, the ability to form new memories is nearly absent. A person with Wernicke-Korsakoff Syndrome will repeat comments or questions several times during a conversation and will forget they already greeted you. This is because they have no memories of any event that occurs after the onset of their illness.
The symptoms of Wernicke’s encephalopathy include:
Encephalopathy (a profound level of mental confusion or disorientation, indifference, and an inability to think clearly)
Delirium Tremens (the DTs, the shakes)
Loss of muscle coordination, ataxia (unsteady or uncoordinated walking)
Vision changes (double vision, drooping eyelids, abnormal eye movements)
The symptoms of Korsakoff’s syndrome include:
Inability to form new memories
Severe loss of memory
Confabulation (Making up stories and believing they’re true)
There can be overlap between the phases and symptoms.
In general, the patient’s social behaviors and attention are fairly well-preserved. Especially in social settings with those who are mere acquaintances, people with Wernicke-Korsakoff’s Syndrome often appear relatively normal and can carry on a conversation that is socially appropriate. In general, patients with Korsakoff’s Syndrome are unaware that anything is wrong with them. Some may experience global dementia, which affects all areas of their lives, and severe cognitive dysfunction.
When people with Korsakoff’s Syndrome experience memory impairment, it is common to find lesions in the anterior thalamus region of their brain. Damaged or shrunken mamillary bodies is also specific to Wernicke’s encephalopathy, so when these are tipoffs to doctors about the causes of dementia in some patients.
How to Treat Wernicke-Korsakoff Syndrome
Treatment goals for people with Wernicke-Korsakoff Syndrome are symptom control and the prevention of disease progression. To achieve these goals, it can be necessary to hospitalize some patients initially. Wernicke encephalopathy, in particular, is an acute syndrome, and since this is the only point at which damage may be reversal, it demands emergency treatment to prevent neurologic problems and death. Therefore, even without a confirmed diagnosis, patients with suspected Wernicke-Korsakoff Syndrome should be treated for the disease as additional evaluations are conducted.
Patients suffering from the early stages of Wernicke-Korsakoff Syndrome often respond well to intense thiamin treatment. This treatment consists of large intravenous doses of thiamin followed by supplemental oral doses. Once the patient’s thiamin deficiency has been reversed, they will see substantial improvement in their symptoms of confusion or delirium, vision problems and lack of muscle coordination. Their symptoms of memory loss and intellect loss rarely improve, however, and late-stage patients will not benefit from thiamin or any other known treatment.
Patients with Korsakoff syndrome usually do not recover. This means that these patients typically require some sort of social support and supervision, at home or in a long-term care facility, for life.
Caring for Someone with Wernicke-Korsakoff Syndrome
Caring for anyone with dementia or other serious neurological problems is a challenge. Caring for a friend, family member, or other loved one who has Wernicke-Korsakoff Syndrome presents a myriad of unique challenges. This kind of patient may exhibit confusing, bizarre behaviors that are not just strange, but also may seem to the caregiver like the patient is still drinking, even if they aren’t. This can lead to an ongoing level of tension and uncertainty for the caregiver.
Alcoholics frequently isolate themselves from their loved ones and engage in activities that strain their relationships. This puts many caregivers in a difficult position; they still love the person with Wernicke-Korsakoff Syndrome, naturally, but they may also be dealing with feelings of resentment, depression, and anxiety after a lifetime of the emotional effects of alcohol abuse. Moreover, since people with Wernicke-Korsakoff Syndrome often have a poor understanding of their disease process and a long history of alcohol abuse, it may be difficult or impossible to convince the patient to stop drinking.
This is why the support of trained medical, mental health, and addiction personnel is so important to caregivers of people with Wernicke-Korsakoff Syndrome. These professionals can help you come up with a plan for caring for your loved one, and preserving your own mental health at the same time. Doctors, case workers, and mental health professionals with experience in addiction and alcoholism are your best bet. Support groups can also be useful to caregivers.
Finally, research proves that alcoholism can be passed along in families. This means that many caregivers are pulling double duty or even more. It also means that caregivers may be struggling with addictions of their own, along with alcohol-related neurological problems. If you are a caregiver to someone with Wernicke-Korsakoff Syndrome, it is critical for you to take special care to reduce your own risk of alcohol-related health problems, so you are better able to avoid alcoholism and its consequences.
Getting Help for Alcoholism and Wernicke-Korsakoff Syndrome
Without treatment, Wernicke-Korsakoff Syndrome will get steadily worse can be life-threatening. In fact, 20 percent of patients with wet brain die. If you or someone you love has a problem with alcohol and exhibits any sign of Wernicke-Korsakoff Syndrome, seek treatment right away.
Depending on which stage of the disorder the patient is in, emergency treatment may be needed and symptoms of alcohol withdrawal must be monitored. After thiamin levels have been restored, the patient should continue recovery and treat their addiction to alcohol at an alcohol rehab. Alcohol rehab will provide a variety of treatment options, including detox, counseling, group and individual therapy, residential treatment programs, education and family involvement. Help prevent the damaging effects of Wernicke-Korsakoff Syndrome and other alcohol-induced consequences by seeking treatment at an alcohol rehab today.