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Wernicke-Korsakoff Syndrome

by Juebin Huang, MD, PhD

This unusual form of amnesia may develop in alcoholics and other malnourished people, usually because of a deficiency of thiamin (vitamin B 1 ). Rarely, this syndrome results from a head injury (called a traumatic brain injury).

Wernicke-Korsakoff syndrome combines two disorders: an acute confusional state (Wernicke encephalopathy—see Wernicke’s Encephalopathy) and a type of long-term amnesia called Korsakoff syndrome (see Korsakoff’s Syndrome). Korsakoff syndrome develops in about 80% of people with untreated Wernicke encephalopathy.

Wernicke encephalopathy causes loss of balance, drowsiness, a tendency to stagger, and eye movement problems in addition to confusion.

Korsakoff syndrome may initially cause severe memory loss for recent events. Memory of more distant past events seems to be less impaired. Thus, people may be able to interact socially and converse coherently even though they cannot remember anything that happened in the preceding few days, months, or years or even in the preceding few minutes. They tend to make things up (confabulate) rather than admit that they cannot remember. Because they cannot remember things they have recently done, they never tire of reading a favorite magazine over and over again.

Treatment consists of thiamin and fluids given intravenously. Such treatment can correct Wernicke encephalopathy, although recovery is usually incomplete. If untreated, Wernicke encephalopathy can be fatal, but death rarely results in developed countries.

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