Wernicke-Korsakoff syndrome

Alternative names:

alcoholic encephalopathy; encephalopathy, alcoholic; Korsakoff psychosis; Wernicke's disease

Treatment:

The goals of treatment are to control symptoms as much as possible and to prevent progression of the disorder. Hospitalization is required for initial control of symptoms. If the person is lethargic, unconscious, or comatose, monitoring and care appropriate to the condition may be required. The airway should be monitored and protected as appropriate.

Thiamine (vitamin B-1) may improve symptoms of confusion or delirium, difficulties with vision and eye movement, and muscle incoordination. B-1 may be given by injection into a vein or a muscle, or by mouth. Thiamine does not generally improve loss of memory and intellect associated with Korsakoff psychosis.

Total abstinence from alcohol is required to prevent progressive loss of brain function and damage to peripheral nerves. A well-balanced, nourishing diet is recommended.

Support groups:

The stress of illness can often be helped by joining a support group where members share common experiences and problems. See alcoholism - support group.

Expectations (prognosis):

Without treatment, Wernicke-Korsakoff syndrome progresses steadily to death. With treatment, symptoms such as incoordination and vision difficulties may be controlled, and progression of the disorder may be slowed or stopped. Some of the symptoms, particularly the loss of memory and intellect/cognitive skills, may be permanent. There may be a need for custodial care if the loss of intellect/cognitive skills is severe. Other disorders related to the abuse of alcohol may also be present.

Complications:

• permanent loss of memory
• permanent loss of cognitive/intellectual skills
• injury caused by falls
• difficulty with personal/social interaction
• alcohol withdrawal state
• permanent alcoholic neuropathy
• shortened life span

Calling your health care provider:

Call your health care provider if Wernicke-Korsakoff syndrome is present and symptoms worsen or reappear. Also call if new symptoms develop, including symptoms of alcohol withdrawal:

• delirium or confusion.
• agitation.
• jumpiness or nervousness
• insomnia
• hallucinations
• palpitations
• heart rate that is faster than normal without an observable cause such as:
  • increased activity.
  • pale skin
  • profuse sweating
  • muscle tremors
  • seizures
  • headache
  • fever.
  • nausea/vomiting

Discuss the situation with your health care provider if you are unable to care for the person at home.