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Wernicke-Korsakoff syndrome

  • Alternative Names

    Korsakoff psychosis; Alcoholic encephalopathy; Encephalopathy - alcoholic; Wernicke's disease


    Symptoms of Wernicke's encephalopathy:

    • Confusion
    • Loss of muscle coordination (ataxia)
      • Leg tremor
    • Vision changes
      • Abnormal eye movements (back and forth movements called nystagmus)
      • Double vision
      • Eyelid drooping

    Symptoms of Korsakoff syndrome:

    • Inability to form new memories
    • Loss of memory, can be severe
    • Making up stories (confabulation)
    • Seeing or hearing things that aren't really there (hallucinations)

    Note: There may also be symptoms of alcohol withdrawal.

    Signs 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)
    • 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 vitamin B1 levels
    • Transketolase activity in red blood cells (reduced in people with thiamine deficiency)

    Blood or urine alcohol levels and liver enzymes may be high in people with a history of long-term alcohol abuse.

    Other conditions that may cause thiamine deficiency include:

    • AIDS
    • Cancers that have spread throughout the body
    • Extreme nausea and vomiting during pregnancy (hyperemesis gravidarum)
    • Heart failure (when treated with long-term diuretic therapy)
    • Long periods of intravenous (IV) therapy without receiving thiamine supplements
    • Long-term dialysis
    • Very high thyroid hormone levels (thyrotoxicosis)

    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.