Wernicke-Korsakoff Syndrome

What Is It?

Wernicke – Korsakoff syndrome (WKS) is the combined presence of Wernicke’s encephalopathy (WE) and Korsakoff’s syndrome. Due to the close relationship in between these two disorders, people with both are generally detected with WKS, as a single syndrome.

The reason for the condition is thiamine (vitamin B1) deficiency, which can cause a variety of conditions consisting of beriberi, Wernicke’s encephalopathy, and Korsakoff’s psychosis. These conditions might manifest together or separately. WKS is usually secondary to alcoholic abuse. It generally causes vision changes, ataxia and impaired memory.

Wernicke’s encephalopathy and WKS is most frequently seen in individuals who are alcoholic, and only 20% of cases are identified prior to death. This failure in medical diagnosis of WE and thus treatment of the disease causes death in roughly 20% of cases, while 75% are entrusted irreversible mental retardation associated with WKS. Of those affected, 25% need long-lasting institutionalization in order to receive efficient care.

The syndrome also known as Korsakoff psychosis; Alcoholic encephalopathy; Encephalopathy – alcoholic; Wernicke’s disease; Alcohol use – Wernicke; Alcoholism – Wernicke; Thiamine deficiency – Wernicke.

Causes of Wernicke-Korsakoff Syndrome

Wernicke encephalopathy and Korsakoff syndrome are different conditions that typically take place together. Both are because of mental retardation brought on by an absence of vitamin B1.

Lack of vitamin B1 prevails in individuals who have alcohol use disorder. It is likewise common in people whose bodies do not take in food correctly (malabsorption). This can sometimes occur with a chronic health problem or after weight-loss (bariatric) surgery.

Korsakoff syndrome, or Korsakoff psychosis, tends to develop as Wernicke symptoms go away. Wernicke encephalopathy causes brain damage in lower parts of the brain called the thalamus and hypothalamus. Korsakoff psychosis arises from permanent damage to areas of the brain included with memory.

Symptoms of Wernicke-Korsakoff Syndrome

Symptoms of Wernicke encephalopathy include:

  • Confusion and loss of mental activity that can progress to coma and death
  • Loss of muscle coordination (ataxia) that can cause leg tremor
  • Vision modifications such as unusual eye movements (back and forth motions called nystagmus), double vision, eyelid drooping
  • Alcohol withdrawal

Symptoms of Korsakoff syndrome:

  • Inability to form new memories
  • Loss of memory, can be severe
  • Making up stories (confabulation).
  • Seeing or hearing things that are not actually there (hallucinations).

Diagnosis

Examination of the nervous/muscular system might reveal damage to lots of nerve systems:.

  • Irregular eye motion.
  • Decreased or abnormal reflexes.
  • Quick pulse (heart rate).
  • Low blood pressure.
  • Low body temperature.
  • Muscle weakness and atrophy (loss of tissue mass).
  • Problems with walk (gait) and coordination.

The person might appear badly nourished. The following tests are used to examine an individual’s nutrition level:.

  • Serum albumin (associates with person’s basic nutrition).
  • Serum vitamin B1 levels.
  • Transketolase activity in red cell (lowered in people with thiamine deficiency).

Liver enzymes may be high in people with a history of long-term alcoholic abuse.

Other conditions that may cause vitamin B1 shortage consist of:

  • HIV/AIDS.
  • Cancers that have spread out throughout the body.
  • Severe queasiness and vomiting during pregnancy (hyperemesis gravidarum).
  • Heart failure (when treated with long-term diuretic therapy).
  • Extended periods of intravenous (IV) therapy without receiving thiamine supplements.
  • Long-term dialysis.
  • Very high thyroid hormonal agent levels (thyrotoxicosis).

A brain MRI may reveal changes in the tissue of the brain. However if Wernicke-Korsakoff syndrome is believed, treatment should begin immediately. Typically a brain MRI test is not needed.

Treatment for Wernicke-Korsakoff Syndrome

The goals of treatment are to control symptoms and to avoid the disorder from becoming worse. Some individuals might have to remain in the medical facility early in the condition to help control symptoms.

Tracking and unique care might be required if the person is:.

  • In a coma.
  • Sluggish.
  • Unconscious.

Vitamin B1 might be offered by injection into a vein or a muscle, or by mouth. This may enhance symptoms of:

  • Confusion or delirium.
  • Difficulties with vision and eye movement.
  • Lack of muscle coordination.

Vitamin B1 often does not enhance loss of memory and intelligence that accompany Korsakoff psychosis.

Stopping alcohol use can avoid more loss of brain function and damage to nerves. A healthy, nourishing diet can assist, however it is not a replacement for stopping alcohol use.

Outlook (Prognosis)

Without treatment, Wernicke-Korsakoff syndrome gets gradually worse, and can be life threatening. With treatment, it is possible to manage symptoms (such as uncoordinated movement and vision difficulties). This disorder can also be slowed or stopped.

Possible Complications

Complications that may result include:

  • Alcohol withdrawal.
  • Difficulty with personal or social interaction.
  • Injury brought on by falls.
  • Long-term alcoholic neuropathy.
  • Permanent loss of believing skills.
  • Long-term loss of memory.
  • Shortened life expectancy.

When to Contact a Medical Professional

Call your healthcare supplier or go to the emergency clinic if you have symptoms of Wernicke-Korsakoff syndrome, or if you have actually been identified with the condition and your symptoms become worse or return.

Prevention

Not consuming alcohol and getting enough nutrition reduce the risk of establishing Wernicke-Korsakoff syndrome.


Last modified: February 14, 2017

References

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