BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuWernicke-Korsakoff syndromeKorsakoff psychosis; Alcoholic encephalopathy; Encephalopathy - alcoholic; Wernicke's disease; Alcohol use - Wernicke; Alcoholism - Wernicke; Thiamine deficiency - WernickeWernicke-Korsakoff syndrome is a brain disorder due to vitamin B1 (thiamine) deficiency.Vitamin B1 (thiamine) deficiencyBeriberi is a disease in which the body does not have enough thiamine (vitamin B1).Read Article Now Book Mark Article Causes Wernicke encephalopathy and Korsakoff syndrome are not different conditions. They are different stages of the same disease process. Both are due to brain damage caused by a lack of vitamin B1.Lack of vitamin B1 is common in people who have alcohol use disorder. It is also common in people whose bodies do not absorb food properly (malabsorption). This can sometimes occur with a chronic illness or after weight-loss (bariatric) surgery. Alcohol use disorderAlcohol use disorder is when your drinking causes serious problems in your life, yet you keep drinking. You may also need more and more alcohol to f...ImageRead Article Now Book Mark Article Korsakoff syndrome tends to develop after symptoms of Wernicke encephalopathy go away. Wernicke encephalopathy causes brain damage in lower parts of the brain called the thalamus and hypothalamus. Korsakoff syndrome results from permanent damage to areas of the brain involved with memory. Symptoms 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 Loss of muscle coordinationUncoordinated movement is due to a muscle control problem that causes an inability to coordinate movements. It leads to a jerky, unsteady, to-and-fr...Read Article Now Book Mark Article Vision changes such as abnormal eye movements (back and forth movements called nystagmus), double vision, eyelid drooping Abnormal eye movementsNystagmus is a term to describe fast, uncontrollable movements of the eyes that may be:Side to side (horizontal nystagmus)Up and down (vertical nysta...ImageRead Article Now Book Mark Article Double visionThere are many types of eye problems and vision disturbances, such as: Halos Blurred vision (the loss of sharpness of vision and the inability to see...ImageRead Article Now Book Mark Article Eyelid droopingEyelid drooping is excess sagging of the upper eyelid. The edge of the upper eyelid may be lower than it should be (ptosis) or there may be excess b...ImageRead Article Now Book Mark Article Alcohol withdrawalAlcohol withdrawalAlcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol on a regular basis suddenly stops drinking ...Read Article Now Book Mark Article Symptoms of Korsakoff syndrome include:Inability to form new memories Loss of memory, can be severe Making up stories (confabulation) Seeing or hearing things that are not really there (hallucinations)HallucinationsHallucinations involve sensing things such as visions, sounds, or smells that seem real but are not. These things are created by the mind.Read Article Now Book Mark Article Exams and Tests Examination of the nervous/muscular system may show damage to many nerve systems: Abnormal eye movement Decreased or abnormal reflexes Fast pulse (heart rate) Low blood pressure Low body temperature Muscle weakness and atrophy (loss of tissue mass) Loss of tissue massMuscle atrophy is the wasting (thinning) or loss of muscle tissue.ImageRead Article Now Book Mark Article Problems with walk (gait) and coordination The person may appear poorly nourished. The following tests are used to check a person's nutrition level:Serum albumin (relates to person's general nutrition) Serum albuminAlbumin is a protein made by the liver. A serum albumin test measures the amount of this protein in the clear liquid portion of the blood. Albumin c...ImageRead Article Now Book Mark Article Serum vitamin B1 levels Transketolase activity in red blood cells (reduced in people with thiamine deficiency) Liver enzymes may be high in people with a history of long-term alcohol abuse.Other conditions that may cause vitamin B1 deficiency include:HIV/AIDS HIV/AIDSHuman immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the virus attacks and weakens the immune ...ImageRead Article Now Book Mark Article Cancers that have spread throughout the body Extreme nausea and vomiting during pregnancy (hyperemesis gravidarum) Hyperemesis gravidarumHyperemesis gravidarum is extreme, persistent nausea and vomiting during pregnancy. It can lead to dehydration, weight loss, and electrolyte imbalan...Read Article Now Book Mark Article Heart failure (when treated with long-term diuretic therapy) Heart failureHeart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...ImageRead Article Now Book Mark Article Long periods of intravenous (IV) therapy without receiving thiamine supplements Long-term dialysis Very high thyroid hormone levels (thyrotoxicosis)ThyrotoxicosisHyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.ImageRead Article Now Book Mark Article A brain MRI may show changes in the tissue of the brain. But if Wernicke-Korsakoff syndrome is suspected, treatment should start immediately. Usually a brain MRI exam is not needed.MRIA head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...ImageRead Article Now Book Mark Article Treatment The goals of treatment are to control symptoms and to prevent the disorder from getting worse. Some people may need to stay in the hospital early in the condition to help control symptoms.Monitoring and special care may be needed if the person is:In a coma In a comaDecreased alertness is the most severe state of reduced awareness and is a serious condition. A coma is a state of decreased alertness from which a p...Read Article Now Book Mark Article Lethargic LethargicFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Unconscious Vitamin B1 is usually given by injection into a vein or a muscle as soon as possible. This may improve symptoms of:Confusion or delirium ConfusionConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article DeliriumDelirium is sudden severe confusion due to rapid changes in brain function that occur with physical or mental illness.ImageRead Article Now Book Mark Article Difficulties with vision and eye movement Lack of muscle coordination Vitamin B1 often does not improve loss of memory and intellect that occur with Korsakoff syndrome.Stopping alcohol use can prevent more loss of brain function and damage to nerves. A well-balanced, nourishing diet can help, but it is not a substitute for stopping alcohol use. Outlook (Prognosis) Without treatment, Wernicke-Korsakoff syndrome gets steadily worse, and can be life threatening. With treatment, it is possible to control symptoms (such as uncoordinated movement and vision difficulties). This disorder can also be slowed or stopped.Uncoordinated movementUncoordinated movement is due to a muscle control problem that causes an inability to coordinate movements. It leads to a jerky, unsteady, to-and-fr...Read Article Now Book Mark Article Vision difficultiesThere are many types of eye problems and vision disturbances, such as: Halos Blurred vision (the loss of sharpness of vision and the inability to see...ImageRead Article Now Book Mark Article Possible Complications Complications that may result include:Alcohol withdrawal Alcohol withdrawalAlcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol on a regular basis suddenly stops drinking ...Read Article Now Book Mark Article Difficulty with personal or social interaction Injury caused by falls Permanent alcoholic neuropathy Alcoholic neuropathyAlcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol.ImageRead Article Now Book Mark Article Permanent loss of thinking skills Permanent loss of memory Shortened life span When to Contact a Medical Professional Contact your health care provider or go to the emergency room if you have symptoms of Wernicke-Korsakoff syndrome, or if you have been diagnosed with the condition and your symptoms get worse or return. Prevention Not drinking alcohol or drinking in moderation and getting enough nutrition reduce the risk of developing Wernicke-Korsakoff syndrome. If a heavy drinker will not quit, thiamine supplements and a good diet may reduce the chance of getting this condition, but the risk is not eliminated.Open ReferencesReferencesKoppel BS. Nutritional and alcohol-related neurologic disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 388.So YT. Deficiency diseases of the nervous system. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 85.AllVideoImagesTogCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.Central nervous system and peripheral nervous systemillustrationBrain - illustration The major areas of the brain have one or more specific functions.BrainillustrationBrain structures - illustration The structures of the brain include the brainstem, consisting of the spinal cord, the medulla oblongata, the pons and the midbrain; the cerebellum; the cerebrum (one half, or hemisphere shown), and the diencephalon.Brain structuresillustrationCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.Central nervous system and peripheral nervous systemillustrationBrain - illustration The major areas of the brain have one or more specific functions.BrainillustrationBrain structures - illustration The structures of the brain include the brainstem, consisting of the spinal cord, the medulla oblongata, the pons and the midbrain; the cerebellum; the cerebrum (one half, or hemisphere shown), and the diencephalon.Brain structuresillustrationRelated Information Beriberi(Condition)Central nervous system(Special Topic)Peripheral(Special Topic)Alcohol withdrawal(Condition)Thiamin(Nutrition)Alcohol use and safe drinking(Special Topic)Alcohol use disorder(Condition)Alcoholic neuropathy(Condition)Vitamins and Phytonutrients(In-Depth)Alcohol use disorders(In-Depth) Review Date: 2/4/2020 Reviewed By: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Stony Brook University School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 09/30/2021. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.