Wernicke-Korsakoff Syndrome

(Wernicke-Korsakoff's Syndrome)

ByJuebin Huang, MD, PhD, Department of Neurology, University of Mississippi Medical Center
Reviewed/Revised Aug 2023
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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).

Symptoms of Wernicke-Korsakoff Syndrome

Wernicke encephalopathy causes loss of balance, staggering when walking, eye movement problems, confusion, and drowsiness.

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.

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.

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 industrialized countries.

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