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Wernicke-Korsakoff Syndrome

By: S. Rennie, LPN

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Sometimes known as Korsakoff psychosis; Alcoholic encephalopathy; Encephalopathy - alcoholic; or Wernicke's disease, Wernicke's encephalopathy is a degenerative brain disorder caused by the lack of thiamine (vitamin B1). This causes damage to multiple nerves in both the Central Nervous System (CNS) and peripheral nervous system. (CNS = brain and spinal cord; peripheral nervous system = rest of the body.)1,2

Symptoms include changes in vision, such as double vision, eye movement abnormalities, drooping eyelid(s); memory loss or amnesia, confabulation (fabricating stories), attention deficit, disorientation, hallucinations and unsteady, uncoordinated walking.

Heavy, long-term alcohol consumption interferes with the breakdown of thiamine in the body, so even if an alcohol-dependent person follows a well-balanced diet, most of the thiamine is not absorbed.2

Korsakoff's amnesic syndrome or Korsakoff psychosis, tends to develop as Wernicke's symptoms diminish. This involves damage to areas of the brain involved with memory. It is also caused by a lack of thiamine and is tied to alcohol dependence. Those with Korasakoff's Syndrome, make up detailed, believable stories to veil their impaired memory. It is not generally deliberate or meant to be deceitful, because oftentimes the patient believes what s/he is saying.1,2

Even though Wernicke's and Korsakoff's appear to be different disorders, Wernicke's encephalopathy represents the first phase of the disorder, the "acute" phase, and Korsakoff's amnesic syndrome is the second, "chronic" phase.1

Most symptoms can be reversed if detected and treated promptly. Improvement in memory function is slow and generally not fully reversible. This disorder can be treated with replacement of thiamine by vitamin B1 injections into the muscle, vein or tablets by mouth. Complete abstinence is necessary, and a well-balanced diet is recommended. Lack of treatment will cause the syndrome to progress steadily to death.1,2


  1. National Institute of Neurological Disorders and Stroke website. (NINDS is part of the National Institute of Health)
  2. "Wernicke-Korsafoff syndrome". MedlinePlus. A service of the U.S. National Library of Medicine and the National Institutes of Health.

    Wernicke-Korsakoff Syndrome, Author: Alan DeAngelo, MD, Consulting Staff, Department of Internal Medicine, Division of Pulmanary, Critical Care and Sleep Medicine, Dwight David Eisenhower Army Medical Center
    Coauthor: Alan Halliday, MD, Chief of Neurology Service, Brooke Army Medical Center; Clinical Professor, Department of Neurology, University of Texas Health Science Center at San Antonio, and Society of Critical Care Medicine

This page was last modified on : 10/28/2013

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