Wernicke-Korsakoff syndrome is a condition typically caused by years of heavy drinking. It is actually two separate but related conditions–Wernicke’s encephalopathy and Korsakoff’s syndrome. It is caused by a vitamin B1, or thiamine, deficiency.
Wernicke-Korsakoff syndrome begins with the Wernicke’s encephalopathy phase. This condition includes confusion, eye problems, and unsteady standing and walking. All three of these only occur in about 10 percent of cases, but all three are more likely to occur when alcohol is the cause. Someone experiencing Wernicke’s encephalopathy may feel confused, apathetic, or unaware of what’s going on around him. The eye problems include lack of muscle control, which is evident from abnormal eye movements or the eyes not looking in the same direction.
Wernicke’s encephalopathy can also cause a number of other symptoms, including hypothermia, hearing loss, and a variety of other symptoms, depending on the part of the brain where lesions appear.
Korsakoff’s syndrome is a severe memory impairment without impairment of intellectual abilities. Patients with Korsakoff’s syndrome are unable to form new memories and unable to remember things from their past. They may also have aphasia, or trouble speaking, reading, or writing; loss of motor control, such as forgetting how to comb their hair; lose the ability to recognize objects or people; or be unable to adequately control their behavior.
One strange feature of Korsakoff’s syndrome is confabulation. Since people with Korsakoff’s have severe memory impairments but little metacognitive awareness, they often spontaneously invent explanations for what’s happening based on whatever they can remember and other information available to them. For example, someone with Korsakoff’s might tell you he’s in the hospital to have his tonsils out because that’s the only time he can remember being in the hospital, so he figures that must be why he’s there now. He has no intention of deceiving anyone; it’s just the best he can do.
Wernicke-Korsakoff syndrome can be caused by severe malnutrition, but in the US it is almost always caused by excessive drinking. The thiamine deficiency causes the Wernicke’s encephalopathy, which develops into Korsakoff’s syndrome. If Wernicke’s encephalopathy is diagnosed early and treated, it may be reversed before it progresses to Korsakoff’s syndrome. Unfortunately, this rarely happens. About 80 percent of cases are only identified after death. Most people who develop Wernicke-Korsakoff syndrome suffer permanent impairment and about a quarter have to be institutionalized.
The surest way to prevent Wernicke-Korsakoff syndrome is to quit drinking and eat a healthy diet with adequate thiamine. If someone you know is showing symptoms of Wernicke’s encephalopathy, get medical help immediately.
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