Wernicke-Korsakoff Syndrome

Affecting 1-2 percent of the general population, Wernicke-Korsakoff syndrome (WKS) is a neurological condition that is a combination of Wernicke's encephalopathy and Korsakoff syndrome. WKS is often referred to as alcohol-related dementia or alcoholic dementia and is primarily caused by a lack of thiamine. Although this brain disorder is usually treatable, when diagnosed and treated in the early stages, the implications of WKS can be very serious and lead to irreversible dementia. 

At the Long Island Alzheimers and Dementia (LIAD) Center, we help families impacted by all forms of dementia, including WKS. We offer a range of supportive solutions for diagnosed individuals as well as their caregivers. Let's take a closer look at this condition as well as how the LIAD Center offers support. 

What Is Wernicke-Korsakoff Syndrome? 

As we previously mentioned, WKS is actually comprised of two different conditions that often occur together:

• Wernicke encephalopathy
• Korsakoff syndrome

Korsakoff syndrome tends to develop as the symptoms associated with Wernicke go away. Wernicke disease causes damage in the lower parts of the brain called the hypothalamus and thalamus. On the other hand, Korsakoff's psychosis is caused by permanent damage to parts of the brain associated with memory. 

While the conditions are different, they both are due to brain damage resulting from vitamin B1 or thiamine deficiency. This deficiency is relatively common in individuals suffering from alcohol use disorder as well as those whose bodies fail to absorb food nutrients properly. 

What Are the Symptoms Associated with Wernicke-Korsakoff? 

WKS is often characterized by dementia-like symptoms, the most noticeable of which is usually confusion. Specific symptoms associated with Wernicke encephalopathy include:

• Loss of mental acuity and confusion that may lead to a coma and death
• Abnormal eye movements and other vision changes, such as the drooping eyelid, and double vision.
• Reduced coordination of muscles that may lead to leg tremors 
• Alcohol withdrawal

Symptoms of Korsakoff syndrome may include:

• Trouble forming or retaining new memories
• Telling made up stories (confabulation)
•  Hallucinations

Risk Factors & Causes of WKS 

Diet and lifestyle are the two main risk factors associated with WKS. In addition, the major risk factors for developing WKS are chronic alcohol abuse and malnourishment. With chronic alcohol abuse, the body may prevent the proper absorption of vitamin B1, which contributes to this brain disorder. Other risk factors associated with WKS include:

• Malnourishment
• Immune system disorders that can affect vitamin B1 absorption, like AIDS
• Having regular kidney dialysis, which also reduces thiamine absorption

Causes of WKS

Undoubtedly, the number one cause of Wernicke-Korsakoff Syndrome is alcoholism. This connection can be attributed to the fact that those who suffer from alcoholism typically will have a poorer diet. The less common causes of Wernicke-Korsakoff include conditions that restrict nutritional absorption, such as:

1. Colon cancer that causes discomfort when eating
2. Gastric cancer that can limit nutritional absorption
3. Gastric bypass surgery that can make it hard to meet nutritional needs because of smaller food portion size
4. Eating disorders. 

Making a Diagnosis

Far too often, WKS is mistaken for Alzheimer's or another type of dementia. This can delay the process of getting proper treatment. Diagnosis usually involves a thorough physical examination and a review of medical history. Your loved one may also be evaluated for signs of alcoholism. If a lack of sufficient nourishment is suspected, nutritional tests may be done to confirm. There are two primary tests of this nature:

• Serum albumin test: This test measures levels of a protein in the blood associated with nutritional deficiencies as well as liver and kidney problems that could affect food absorption.
• Serum vitamin B1 test: The purpose of this test is to check B1 levels in the blood. This is done by looking at enzyme activity – low levels indicate a B1 deficiency.

Because diagnosing WKS is often done through a process of elimination, additional testing could be performed as well. Some of these may include a CT scan or MRI to look for brain changes or abnormalities. An electrocardiogram may be conducted as well before and after vitamin B1 is taken to see if there's a connection.

How Is WKS Treated? 

If symptoms are severe, initial treatment for WKS may involve hospitalization. If this is the case, B1 might be delivered intravenously, or it may be administered orally. A balanced diet is often recommended as well to increase B1 absorption and restore levels back to normal. In some instances, your loved one may need to be treated separately for alcoholism.

As far as prognosis goes, prompt treatment could reverse the neurological symptoms associated with WKS. However, response to treatment will also depend on factors such as when the condition was first diagnosed and how advanced it was at the time. If not treated, WKS may cause irreversible brain damage.

In either case, the most effective way to prevent WKS is with a balanced diet that includes vitamin B1-rich foods. Options include lean pork, whole wheat bread, peas, brightly colored fruits, and green, leafy veggies. Also, encourage your loved ones to avoid excessive alcohol consumption and encourage them to access the treatment they need for alcohol misuse; and be proactive about any noticeable changes with mental capabilities. 

Contact Long Island Alzheimer's Dementia Center  

If you have a loved one living with Wernicke-Korsakoff Syndrome, the Long Island Alzheimer's and Dementia Center offers an array of support services. 

Contact us today to learn more about how we can help by calling (516) 767-6856 or visiting our website at www.lidementia.org.