Wernicke-Korsakoff Syndrome (Alcohol Related Dementia or ARDS)

What is Wernicke-Korsakoff Syndrome?

Wernicke-Korsakoff Syndrome, also known as Alcohol Related Dementia Syndrome (ARDS), is a neurological condition caused by a deficiency of thiamin (Vitamin B1). Thiamin is essential for brain function. When the brain doesn’t have enough thiamin, it can lead to two conditions: Wernicke’s encephalopathy and Korsakoff syndrome.

Wernicke’s encephalopathy is the acute phase where the brain is inflamed. If it is not treated quickly, it can progress to become Korsakoff syndrome, which causes long-term impairment of the brain.

As this condition is mostly commonly associated with chronic alcohol misuse, Wernicke-Korsakoff syndrome is often called Alcohol Related Dementia Syndrome (ARDS).

Who is Affected?

• Wernicke-Korsakoff Syndrome is mostly commonly experienced by adults with a long history of alcohol misuse. Alcohol interferes with the body’s ability to absorb, store and use thiamin.
• The condition can also occur in individuals with severe nutritional deficiencies from eating disorders, gastrointestinal surgery, cancer treatment and other conditions that impact nutrient absorption.

What are the Causes & Risk Factors?

• Wernicke-Korsakoff syndrome is caused by a prolonged, severe deficiency of thiamin (Vitamin B1).
• The thiamin deficiency was often caused by long-term alcohol misuse, but it can also be from medical conditions that impact nutrient absorption.

Uncontrollable Risk Factors

• Medical conditions that impair absorption such as GI disorders or surgery

Controllable Risk Factors

• Chronic alcohol misuse
• Poor nutrition

What are the Signs & Symptoms?

The symptoms depend on which phase the condition is in (acute or chronic).

Acute Phase Symptoms (Wernicke’s encephalopathy)

• Confusion or changes in mental status
• Poor coordination or difficulty walking
• Eye movement abnormalities or vision changes

Chronic Phase Symptoms (Korsakoff syndrome)

• Sever memory problems
• Difficulty learning new information
• Personality or behavior changes
• Poor judgement and decision making
• Ongoing problems with balance or coordination

How is Wernicke-Korsakoff Syndrome Diagnosed?

Diagnosis is based on symptoms, medical history, nutritional stats and risk factors, such as alcohol use.

Tests that May Be Used

• Physician and neurological examination
• Blood tests to assess nutritional deficiencies
• Brain imaging
• Evaluation of alcohol use and nutritional history

How is Wernicke-Korsakoff Syndrome Treated?

Prompt treatment is critical during the acute phase to present the progression of the disease. Early intervention may allow partial or full recovery of cognitive function.

Lifestyle

• Complete abstinence from alcohol
• Long-term nutritional support
• Balanced diet rich in essential vitamins

Devices

• Mobility aids if balance or coordination is impaired

Medical

• Thiamin (Vitamin B1) replacement
• Ongoing vitamin supplementation
• Treatment of complications related to alcohol use
• Treatment of complications related to malabsorption conditions

Surgical

• There are no surgical treatments

Other

• Physical therapy to improve balance and walking
• Occupational therapy to support daily activities
• Speech therapy to support speech and swallowing
• Support programs for alcohol use disorder

When to See Your Doctor

You should talk to your doctor if you or a loved one has a history of heavy alcohol use or malnutrition and develops confusion, memory problems, balance issues or changes in behavior.

When to Seek Emergency Medical Care

Seek immediate medical attention if symptoms such as confusion, difficulty walking or eye movement abnormalities appear, as Wenicke’s encephalopathy is a medical emergency. And, some of the those symptoms could indicate other neurological emergencies, such as a stroke and need immediate medical evaluation.

Many conditions can affect memory, and not all memory loss is caused by dementia. But, if you or a loved one have noticed increased confusion, changes in behavior or developed balance issues, especially if there is a history of heavy alcohol use or malnutrition, start by talking with your primary care provider. They can help identify possible causes and refer you to a neurologist if additional testing or specialized care is needed.

Visit Understanding Memory to learn more about the many things than can impact memory.

To learn more and connect with support, visit Riverside Health’s Martha W. Goodson Center.