October 9, 2017

Wernicke-Korsakoff Syndrome

Korsakoff syndrome is a chronic memory disorder caused by severe thiamine (vitamin B-1) deficiency, a common consequence of alcoholism. Thiamine helps brain cells produce energy from sugar; when levels fall too low, brain cells cannot generate enough energy to function properly. Symptoms of Korsakoff syndrome include severe loss of memory, confabulation (making up stories), and hallucinations.

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Korsakoff syndrome is often, but not always, preceded by an episode of Wernicke encephalopathy, which is an acute brain reaction to a severe lack of thiamine. Wernicke encephalopathy is a medical emergency that causes life-threatening brain disruption, confusion, staggering and stumbling, lack of coordination, and abnormal involuntary eye movements. When Wernicke's encephalopathy accompanies Korsakoff's syndrome the combination is called Wernicke–Korsakoff syndrome. Experts argue whether Wernicke-Korsakoff syndrome (WKS) is two separate but linked disorders, or if it is a spectrum of a single disease state.

Wernicke-Korsakoff syndrome causes problems learning new information, inability to remember recent events and long-term memory gaps. Memory problems may be strikingly severe while other thinking and social skills are relatively unaffected. Individuals may be able to carry on a coherent conversation, but moments later be unable to recall that the conversation took place or with whom they spoke.

The goals of treatment are to control symptoms and to prevent the disorder from getting worse. Vitamin B1 may be given by injection into a vein or a muscle, or by mouth, which may improve symptoms of confusion or delirium, lack of muscle coordination and difficulties with vision and eye movement.

Without treatment, Wernicke-Korsakoff syndrome gets steadily worse, and can be life threatening. With treatment, it is possible to control symptoms and even slow or stop the disorder entirely.

A medical workup for memory loss or other cognitive changes should always include questions about an individual's alcohol use. Anyone admitted to the hospital for an alcohol-related condition should be professionally screened for memory loss and cognitive change.