Wernicke-Korsakoff syndrome

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Central nervous system

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

• Vision changes
  • Double vision
  • Eye movement abnormalities
  • Eyelid drooping
• Loss of muscle coordination
  • Unsteady, uncoordinated walking
• Loss of memory, can be profound
• Inability to form new memories
• Confabulation (making up stories)
• Hallucinations

Examination of the nervous/muscular system may show damage to multiple nerve systems. Reflexes may be decreased or abnormal. The person's walk (gait) and coordination will be tested. Muscles may be weak and may show atrophy (loss of tissue mass).

Examination of the eyes shows abnormalities of eye movement.Blood pressure and body temperature measurement may be low. Pulse (heart rate) may be rapid.

The person may appear malnourished. The following tests are used to check a person's nutrition level and may confirm malnourished state.

• Serum B1 levels may be low.
• Pyruvate is high.
• Transketolase activity is decreased.

Blood or urine alcohol levels and liver enzymes may be high if the person has a history of chronic (long-term) alcohol abuse.

Other chronic conditions that may cause thiamine deficiency include:

• AIDS
• Hyperemesis gravidarum (continuous nausea and vomiting during pregnancy)
• Thyrotoxicosis (very high thyroid hormone levels)
• Cancers that have spread throughout the body
• Long-term dialysis
• Congestive heart failure, when treated with long-term diuretic therapy

A brain MRI rarely shows changes in the tissue of the brain indicating Wernicke-Korsakoff syndrome.

Review Date: 09/10/2006
Reviewed By: Daniel Kantor, MD, Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.