Wernicke-Korsakoff syndrome

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Central nervous system

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

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.

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

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.

• Permanent loss of memory
• Permanent loss of cognitive skills
• Injury caused by falls
• Difficulty with personal or social interaction
• Alcohol withdrawal state
• Permanent alcoholic neuropathy
• Shortened life span

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.