Merck Manual

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Wernicke-Korsakoff Syndrome

(Wernicke-Korsakoff's Syndrome)


Juebin Huang

, MD, PhD, Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center

Last full review/revision Sep 2020| Content last modified Sep 2020
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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.

Wernicke-Korsakoff syndrome may develop in people who abuse alcohol and other malnourished people, usually because of a deficiency of thiamin (vitamin B1). Rarely, this syndrome results from a head injury (a traumatic brain injury).


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 may, for example, never tire of reading a favorite magazine over and over again.


  • A doctor's evaluation

Doctors suspect Wernicke-Korsakoff syndrome in people who have the characteristic symptoms and who have a disorder that can cause this syndrome (such as undernutrition or a thiamin deficiency), especially if they also abuse alcohol.

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


  • Thiamin and fluids given intravenously

Treatment consists of thiamin and fluids given intravenously. Such treatment can correct Wernicke encephalopathy, although recovery is usually incomplete. Korsakoff syndrome does not resolve.

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

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