Skip navigation | ||
|
||
Medical Encyclopedia |
|
Other encyclopedia topics: | A-Ag Ah-Ap Aq-Az B-Bk Bl-Bz C-Cg Ch-Co Cp-Cz D-Di Dj-Dz E-Ep Eq-Ez F G H-Hf Hg-Hz I-In Io-Iz J K L-Ln Lo-Lz M-Mf Mg-Mz N O P-Pl Pm-Pz Q R S-Sh Si-Sp Sq-Sz T-Tn To-Tz U V W X Y Z 0-9 |
Contents of this page: | |
|
Alternative names Return to top
Korsakoff psychosis; Alcoholic encephalopathy; Encephalopathy - alcoholic; Wernicke's diseaseDefinition Return to top
Wernicke-Korsakoff syndrome is a brain disorder involving loss of specific brain functions caused by a thiamine deficiency.Causes, incidence, and risk factors Return to top
The syndrome is actually a spectrum, including two separate sets of symptoms, one of which tends to start when the other subsides. Wernicke's encephalopathy involves damage to multiple nerves in both the central nervous system (brain and spinal cord) and the peripheral nervous system (the rest of the body).It may also include symptoms caused by alcohol withdrawal. The cause is generally attributed to malnutrition, especially lack of vitamin B1 (thiamine), which commonly accompanies habitual alcohol use or alcoholism.
Heavy alcohol use interferes with the metabolism of thiamine, so even in the unusual cases where alcoholics are eating a balanced diet while drinking heavily, the metabolic problem persists because most of the thiamine is not absorbed.
Korsakoff syndrome, or Korsakoff psychosis, tends to develop as Wernicke's symptoms diminish. It involves impairment of memory out of proportion to problems with other cognitive functions.
Patients often attempt to hide their poor memory by confabulating. The patient will create detailed, believable stories about experiences or situations to cover gaps in memory. This is not usually a deliberate attempt to deceive because the patient often believes what he is saying to be true. It can occur whether or not the thiamine deficiency was related to alcoholism and with other types of brain damage.
Korsakoff psychosis involves damage to areas of the brain involved with memory.
Symptoms Return to top
Signs and tests Return to top
The person may appear cachectic (malnourished). A nutritional assessment may confirm malnourished state.
If the history is significant for chronic (long-term) alcohol abuse, serum or urine alcohol levels may be elevated (see toxicology screen) and liver enzymes may be elevated.
Other chronic conditions that may cause a thiamine deficiency include the following:
A brain MRI rarely shows changes in the tissue of the brain indicating Wernicke-Korsakoff syndrome.
Treatment Return to top
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 B1) may improve symptoms of confusion or delirium, difficulties with vision and eye movement, and muscle incoordination. Vitamin B1 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 Return to top
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) Return to top
Without treatment, Wernicke-Korsakoff syndrome progresses steadily to death. With treatment, symptoms (such as uncoordinated movement and vision difficulties) may be controlled, and progression of the disorder may be slowed or stopped.
Some symptoms -- particularly the loss of memory and cognitive skills -- may be permanent. There may be a need for custodial care if the loss of cognitive skills is severe.
Other disorders related to the abuse of alcohol may also be present.
Complications Return to top
Wernicke's encephalopathy may be precipitated in at-risk people by carbohydrate loading or glucose infusion. Supplementation with thiamine must precede glucose infusion to prevent this.
Calling your health care provider Return to top
Call your health care provider if symptoms suggesting Wernicke-Korsakoff syndrome occur, or if the condition has been diagnosed and symptoms worsen or reappear.
Also call if new symptoms develop, particularly symptoms of alcohol withdrawal. Alcohol withdrawal can be fatal, so call the local emergency number (such as 911) or go to the emergency room if any severe symptoms occur.
Symptoms of alcohol withdrawal include:
Delirium or confusion
Prevention Return to top
Abstinence or moderate alcohol use and adequate nutrition reduce the risk of developing Wernicke-Korsakoff syndrome. If a heavy drinker is determined not to quit, thiamine supplementation and a good diet may help prevent the development of this condition, but not if damage has already occurred. Update Date: 7/20/2004 Updated by: Joseph V. Campellone, M.D., Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network.
Home | Health Topics | Drug Information | Encyclopedia | Dictionary | News | Directories | Other Resources | |
Copyright | Privacy | Accessibility | Selection Guidelines U.S. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894 National Institutes of Health | Department of Health & Human Services |
Page last updated: 28 October 2004 |