Merck Manual

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Wernicke-Korsakoff Syndrome

(Wernicke-Korsakoff's Syndrome)

By

Juebin Huang

, MD, PhD, Department of Neurology, University of Mississippi Medical Center

Reviewed/Revised Dec 2021 | Modified Sep 2022
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Wernicke-Korsakoff syndrome is an unusual form of amnesia that combines two disorders: an acute confusional state (Wernicke encephalopathy) and a type of long-term amnesia called Korsakoff syndrome. Korsakoff syndrome develops in about 80% of people with untreated Wernicke encephalopathy.

Symptoms of Wernicke-Korsakoff Syndrome

Korsakoff syndrome Korsakoff Psychosis Korsakoff psychosis is a complication of long-term thiamin deficiency and causes memory loss for recent events, confusion, and behavioral changes. It is frequently diagnosed along with Wernicke... read more 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 may, for example, never tire of reading a favorite magazine over and over again.

Diagnosis of Wernicke-Korsakoff Syndrome

  • A doctor's evaluation

Doctors suspect Wernicke-Korsakoff syndrome in people who have the characteristic symptoms and who have a disorder that can cause thiamin deficiency (such as undernutrition) It is especially common among malnourished people with alcohol use disorder Alcohol Use Alcohol (ethanol) is a depressant (it slows down brain and nervous system functioning). Consuming large amounts rapidly or regularly can cause health problems, including organ damage, coma,... read more .

Tests, such as blood tests to measure blood sugar and electrolyte levels, a complete blood cell count, liver function tests, and imaging of the brain, are usually done to rule out other causes. Sometimes doctors measure the thiamin level in blood.

Treatment of Wernicke-Korsakoff Syndrome

  • Thiamin and fluids given by vein (intravenously)

Wernicke-Korsakoff syndrome is a medical emergency. Treatment consists of thiamin given intravenously. It can correct Wernicke encephalopathy, although recovery is often incomplete if treatment was delayed. Despite treatment, symptoms of Korsakoff syndrome may persist and not resolve.

If untreated, Wernicke encephalopathy can be fatal, but death rarely results in developed countries.

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