Wernicke-Korsakoff Syndrome: Signs, Effects, and Treatments
How is Alcohol Misuse Connected to Wernicke-Korsakoff Syndrome?
Thiamine (vitamin B1) is an essential nutrient utilized by all parts of the body which can only be obtained through diet. Thiamine deficiency can cause damage to the brain, nerves, and heart.
In the United States, alcohol misuse is the leading cause of thiamine deficiency, and consequently the development of WKS.
Chronic alcohol misuse can lead to thiamine deficiency through poor nutrition and malabsorption. For example, people who drink heavily often do not eat a balanced diet and do not take in sufficient levels of thiamine to meet their nutritional needs. Indeed, studies show that chronic drinkers consume lower levels of thiamine.
For the body to absorb thiamine, it must pass through the gastrointestinal tract to be transported to the tissues of the body, and absorption is decreased in people who chronically misuse alcohol. Alcohol use can create inflammation in the digestive tract, which makes it far more difficult for the body to absorb thiamine. Heavy drinking can also make it difficult for the body to effectively process and utilize thiamine in the cells of the body. Thiamine is essential for building enzymes that play important roles in processing and converting sugar into energy and creating chemical messengers in the brain and genetic material in the cells.
Who is at Risk for Developing Wernicke-Korsakoff Syndrome?
As previously mentioned, a thiamine deficiency is a common cause of Wernicke’s encephalopathy. This lack of vitamin B1 may result from chronic alcohol misuse, dietary deficiencies, prolonged vomiting, eating disorders, or the effects of chemotherapy.
For individuals who repeatedly misuse alcohol or suffer from an alcohol use disorder, alcohol can impair the absorption of thiamine from the intestine, decrease the levels of stored thiamine in the liver, and other nutritional deficiencies.
Thiamine helps brain cells produce energy from sugar. When levels fall too low, brain cells can’t generate enough energy to function properly.
Additionally, a thiamine deficiency impacts the cerebellum, mammillary bodies, thalamus, hypothalamus, and brainstem—areas of the brain responsible for balance, coordination, reflexes, cognition, memory, body temperature, appetite, emotions, blood pressure, and sleep.
A thiamine deficiency from heavy alcohol consumption may contribute to the cognitive deficits associated with alcohol misuse, such as memory, attention, and problem-solving impairments.
Wernicke-Korsakoff Syndrome Symptoms
The typical symptoms of WKS can seem similar to those of intoxication. However, the symptoms of WKS persist in the absence of drinking. In addition to the long-term physical and mental deterioration, WKS can also lead to reduced consciousness, coma, or even death in some cases.
Wernicke’s Encephalopathy Symptoms
As mentioned, WKS is comprised of two characteristic parts. The first component of WKS is Wernicke’s encephalopathy (WE), which is a short-term neurological disorder.
The three hallmark signs of WE include mental confusion and apathy, loss of muscular coordination while standing or walking, and eye movement dysfunction and vision disturbances. The nerves that control the eyes may become paralyzed in people who suffer from WE, leading to involuntary eye movements, drooping eyelids, and difficulty tracking objects properly. Coordination issues can cause people with WE to walk with a stagger, and in severe cases, to lose the ability to walk.
While there are three characteristics of WE, a person does not have to exhibit all three of these symptoms to have the disorder. Studies have shown that many cases of WE were undiagnosed because all three symptom types weren’t exhibited, making holistic evaluation of a patient even more critical. WE is caused by thiamine deficiency and is reversible, but treatment must be provided as quickly as possible to ensure better treatment outcomes.
Korsakoff Psychosis Symptoms
Around 80% to 90% of people who misuse alcohol and have WE go on to develop Korsakoff’s psychosis, a form of neuropsychiatric dementia.
Korsakoff’s psychosis is seen as a residual condition that results when WE isn’t treated quickly and effectively, resulting in a range of symptoms that can become detrimental to a person’s ability to function. This condition may also be referred to as “alcohol amnestic disorder” or “alcoholic dementia.”
Symptoms of Korsakoff’s psychosis include amnesia, hallucinations, and changes in behavior. Memory issues may involve difficulty remembering past information (retrograde amnesia) and trouble forming new memories (anterograde amnesia), which can lead to confabulation, the formation of stories to make up for gaps in one’s memory.
Severe memory loss and other damage associated with Korsakoff’s psychosis could become permanent. People with this disorder may not even realize that they have any symptoms and may show certain behavioral changes, such as becoming apathetic, irritable, or displaying less emotion that normal.
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