Wernicke-Korsakoff syndrome overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Aditya Govindavarjhulla, M.B.B.S. [3]

Overview

Wernicke-Korsakoff syndrome is a is a degenerative brain disorder cause by thiamine deficiency. This is usually secondary to alcohol abuse. Although Wernicke's and Korsakoff's may appear to be two different disorders, they are generally considered to be different stages of the same disorder, which is called Wernicke-Korsakoff syndrome(WKS). Wernicke's encephalopathy represents the acute phase of the disorder, and Korsakoff's amnesic syndrome represents the chronic phase.

Historical Perspective

The syndrome is a combined manifestation of two eponymous disorders, Korsakoff's Psychosis and Wernicke's encephalopathy, named for Drs. Sergei Korsakoff and Carl Wernicke.

Daignosis

MRI

MRI may show changes in the brain tissue - atrophy of mammilary body.

Treatment

Medical Therapy

Treatment consists of reversing the thiamine deficiency by giving supplemental thiamine, usually by starting with an initial intravenous or intramuscular dose followed by supplemental oral doses. It is important to start the thiamine treatment before giving any glucose as the encephalopathy will be worsened by the glucose. (Glucose administration promotes dehydrogenation of pyruvate, a biochemical reaction which consumes thiamine.) By the time amnesia and psychosis have occurred, complete recovery is unlikely.

Primary Prevention

Not drinking alcohol or drinking in moderation and getting enough nutrition reduce the risk of developing Wernicke-Korsakoff syndrome. Thiamine supplements and a good diet may reduce the chance of getting this condition, but do not eliminate the risk.

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