Wernicke-Korsakoff Syndrome — once referred to as wet brain syndrome — can be a devastating side effect of long-term alcohol abuse. WKS can be caused by a host of conditions that lead to malnutrition, such as cancer, AIDS, eating disorders, and certain types of surgery. However, it is estimated that around 90% of cases of Wernicke encephalopathy (the first stage of WKS) are caused by untreated alcohol use disorder[1]. 

What is Wernicke-Korsakoff Syndrome?

Wernicke-Korsakoff Syndrome (WKS), often referred to as “wet brain” or wet brain syndrome, is a degenerative neurological disorder caused by a lack of vitamin B1 (thiamine). WKS causes severe brain and memory problems and requires immediate treatment upon diagnosis.

WKS is composed of two separate conditions or stages:

• Wernicke’s encephalopathy: A sudden and severe (acute) brain disorder and the first stage of WKS; characterized by confusion, abnormal eye movements, vision changes, and loss of muscular coordination
• Korsakoff syndrome: A chronic memory disorder and the second stage of WKS; characterized by significant impairment in memory and learning capabilities, as well as disorientation and apathy

WKS is most commonly diagnosed in men between 30 and 70, with the highest concentration in those older than 40. It is rarely seen in children and, if reported in women, is typically attributed to causes other than long-term alcohol dependency. While only 1 to 2% of the general population develops WKS, the prevalence rate is between 12 and 14% in people who drink heavily[2]. 

WKS and Alcohol Use Disorder

WKS results from a severe deficiency in thiamine (vitamin B1), an essential nutrient naturally found in meat, fish, and whole grains and often added to cereals and breads. Vitamin B1 is critical to a healthy diet because it helps the body change carbohydrates into energy. It is essential to a healthy brain, nervous system, and muscle.

Because many foods in the U.S. are fortified with thiamine, most healthy people get an adequate amount in their diets. In people who consistently eat a poor diet or have certain health conditions, however, a lack of thiamine can lead to serious health problems. The condition most commonly associated with Wernicke-Korsakoff syndrome is chronic alcohol dependency.

Alcohol use disorder is a powerful disease that can impair a person in virtually every aspect of their lives, including their ability to eat a balanced diet or prioritize their health and nutrition. 

People in the grips of alcohol use disorder may prioritize buying alcohol over buying nutritious food or preparing healthful meals. The effects of alcohol may alter their appetite so that they eat very little or rely on prepackaged convenience foods that are loaded with sodium, carbs, or sugar. 

Another factor that contributes to vitamin B1 deficiency is alcohol-related inflammation in the stomach and intestinal lining. Thiamine must pass through the digestive system to arrive in other body parts. However, when the gastrointestinal tract is inflamed from prolonged heavy alcohol use, it can compromise a person’s absorption of essential vitamins and nutrients in the foods they eat.

Long-term nutrient deficiencies can take a catastrophic toll on multiple organ systems, causing serious side effects and even critical illness.

Symptoms of WKS

Wernicke-Korsakoff syndrome causes a variety of symptoms, some of which are similar to those caused by alcohol intoxication. The difference, however, is that the symptoms of WKS persist even after a person has stopped drinking. 

Wernicke Encephalopathy Signs and Symptoms

Wernicke encephalopathy is the first stage of WKS. It is an acute brain disorder characterized by the sudden development of multiple symptoms: 

• Mental confusion
• Vision problems
• Hypothermia
• Low blood pressure
• Lack of muscle coordination (ataxia)
• Coma

Korsakoff Syndrome Signs and Symptoms

Korsakoff syndrome is the second stage of WKS. It develops following the acute neurological symptoms of Wernicke encephalopathy and causes damage to nerve cells and supporting cells in the spinal cord and brain. Symptoms of Korsakoff syndrome include:

• Vision problems
• Tremors
• Amnesia
• Disorientation
• Coma

Long-Term Effects of Wernicke-Korsakoff

Wernicke encephalopathy is often reversible when it’s caught and treated early on. However, if it goes untreated, Wernicke can quickly progress into Korsakoff syndrome and cause debilitating and irreversible long-term effects. Ataxia (involuntary muscle movements), involuntary eye movements, and speech impediments are all long-term complications of WKS.

In some cases, the effects of WKS may be so damaging and severe that they require long-term hospitalization or institutionalization. Less than 10% of individuals who develop WKS recover enough to be discharged from long-term care[3]. Those who recover still experience a decreased quality of life and a significantly diminished life expectancy. One study revealed that 50% of patients with WKS are expected to die within eight years of diagnosis[4].

Treatment for WKS

The most important thing a person can do when they notice the early symptoms of WKS is to stop drinking immediately. Medically supervised detox is typically the safest way for people with long-term alcohol use disorder to get sober.

People with symptoms of Wernicke’s encephalopathy or WKS need urgent medical attention to address their thiamine deficiency. Medically administered doses of vitamin B1 are vital to limiting the condition’s most severe and irreversible effects. With WKS, time is of the essence; the sooner a person with symptoms stops drinking and gets appropriate medical attention, the better chance they have of recovery. 

If you or a loved one is struggling to control your drinking, it’s essential to understand the potential health complications and side effects that can result. It’s also important to know that sobriety and recovery are possible with the proper treatment and support. 

STR Behavioral Health in Pennsylvania provides safe, medically supervised detox and intensive residential addiction treatment for alcohol use disorder. Our clinical team gives people the tools to get sober and build the skills, coping mechanisms, and social ecosystem they need for long-lasting recovery and healing.  

If you want to learn more about addiction treatment with STR Behavioral Health, call us or submit an online contact form to speak with an admissions specialist. We will outline your options, help you determine which program best suits your needs, and get you started with the admissions process so you can get on the road to sobriety and recovery today.

Resources

1. Chandrakumar, Abin, et al. “Review of Thiamine Deficiency Disorders: Wernicke Encephalopathy and Korsakoff Psychosis.” Journal of Basic and Clinical Physiology and Pharmacology, vol. 30, no. 2, 2 Oct. 2018, pp. 153–162, https://doi.org/10.1515/jbcpp-2018-0075.
2. National Institute of Neurological Disorders and Stroke. (2023) Wernicke-Korsakoff Syndrome.
3. Alcohol and Alcoholism. (2009). The Korsakoff Syndrome: Clinical Aspects, Psychology and Treatment.
4. Alcohol and Alcoholism. (2017). Long-Term Mortality of Patients with an Alcohol-Related Wernicke-Korsakoff Syndrome.