Wernicke-Korsakoff syndrome

Wernicke-Korsakoff syndrome

Wernicke-Korsakoff syndrome or Wernicke-Korsakoff syndrome (WKS) is a disorder of the brain caused by a deficiency (deficiency) of vitamin B1. This disorder is a combination of Wernicke's disease and Korsakoff's syndrome.

Another name for Wernicke-Korsakoff syndrome is dry beriberi. Although both are caused by a deficiency of vitamin B1, the symptoms of this syndrome are different from wet beriberi, which causes symptoms such as swelling of the legs.

Wernicke's disease and Korsakoff's syndrome are two different conditions. However, the two conditions are interrelated and can appear gradually. Wernicke's disease generally appears first, then Korsakoff's syndrome will occur if Wernicke's disease is not treated immediately.

Causes of Wernicke-Korsakoff Syndrome

The cause of Wernicke-Korsakoff syndrome is a deficiency of vitamin B1 or thiamine . Thiamine functions to help the brain and nervous system convert sugar into energy. Deficiency of vitamin B1 will interfere with the work of the brain and nervous system, and cause damage to the brain, including the thalamus and hypothalamus.

Vitamin B1 deficiency is commonly caused by alcoholism and malnutrition. Alcohol addiction is a major cause of thiamine deficiency or deficiency. This is because alcohol can decrease the body's ability to absorb and store this vitamin.

Apart from alcohol addiction, the following conditions can also increase the risk of thiamine deficiency:

  • Have an eating disorder, such as anorexia nervosa
  • Suffering from gastrointestinal disorders, such as stomach cancer and colon cancer
  • Suffering from kidney disorders that require long-term hemodialysis (dialysis).
  • Suffering from certain diseases, such as HIV/AIDS
  • Suffering from heart failure requiring long-term diuretic therapy
  • Experiencing persistent vomiting
  • Suffering from hyperemesis gravidarum (in pregnant women)
  • Undergoing bariatric surgery or chemotherapy
  • Suffering from thyrotoxicosis

Other conditions that make it difficult for a person to access healthy food, such as poverty and war, can also increase the risk of Wernicke-Korsakoff syndrome.

Wernicke-Korsakoff syndrome is more common in men, people aged 45–65 years, people living alone, and people with mental disorders.

Symptoms of Wernicke-Korsakoff Syndrome

Wernicke-Korsakoff syndrome is preceded by Wernicke's disease or Wernicke's encephalopathy . Wernicke's disease has three characteristic symptoms, namely:

  • Eye disorders, such as diplopia (double or ghosted seeing), ptosis (drooping of the eyelids), and nystagmus (rapid and uncontrollable movement of the eyeballs)
  • Impaired coordination, such as ataxia , weakness in the legs, difficulty standing and walking, and tremors
  • Mental disturbances and consciousness, such as confusion and loss of consciousness

Wernicke's disease can also cause problems with the heart and blood vessels. It is characterized by the following conditions:

  • Faint
  • pounding heart ( palpitations )
  • Low blood pressure ( hytension )
  • Weakness or fatigue for unknown reasons

Wernicke's disease that is not treated immediately will develop into Korsakoff's syndrome. Korsakoff's syndrome can be characterized by the following symptoms:

  • Cannot remember events after this syndrome appeared ( anterograde amnesia )
  • Has difficulty understanding information
  • Having trouble stringing words together
  • Experiencing hallucinations , such as hearing or seeing things that aren't really there
  • Doing confabulation, which is making up exaggerated stories to complete the missing parts in memory

The symptoms of Korsakoff's syndrome usually appear after the symptoms of Wernicke's disease subside.

When to see a doctor

Immediately consult a doctor if you experience the symptoms above. Wernicke-Korsakoff syndrome needs to be treated as soon as possible to prevent complications and permanent damage to the brain.

People who are addicted to alcohol or suffer from disorders that can inhibit the absorption of nutrients, such as anorexia and stomach cancer, are more at risk of Wernicke-Korsakoff syndrome.

If you experience this condition, check with your doctor to get treatment. That way, Wernicke-Korsakoff syndrome can be prevented.

Diagnosis of Wernicke-Korsakoff Syndrome

To diagnose Wernicke-Korsakoff syndrome, the doctor will ask about the patient's symptoms and medical history. Next, the doctor will perform a thorough physical examination, including vital signs such as body temperature, heart rate, respiratory rate and blood pressure.

In addition, the doctor will examine muscle strength and examine the nerves .

To confirm Wernicke-Korsakoff syndrome, the doctor will carry out a number of the following supporting examinations:

  • Blood test , to check the levels of thiamine and alcohol in the blood
  • Electrocardiography (EKG), to measure the electrical activity of the heart before and after taking thiamine supplements
  • CT scan or MRI , to detect brain damage due to Wernicke-Korsakoff syndrome

Treatment of Wernicke-Korsakoff Syndrome

Treatment of Wernicke-Korsakoff syndrome aims to relieve symptoms, stop the disease from progressing, and prevent complications. Treatment methods include administering vitamin B1 supplements and managing a diet high in vitamin B1. The stages are as follows:

  • Administration of vitamin B1 supplements by injection
  • Provision of vitamin B1 tablet supplements
  • Setting a diet rich in vitamin B1

If the patient is so weak that he loses consciousness, he needs to get intensive care at the hospital so that his condition and response to treatment can be monitored.

If the patient's condition is stable, treatment can be continued on an outpatient basis. The duration of treatment can vary, can even reach several months.

Patients with Wernicke-Korsakoff syndrome caused by alcohol addiction also need to get rehabilitation to stop alcohol addiction. If the patient has difficulty walking or has other physical problems, physiotherapy can be done.

The success rate of treating Wernicke-Korsakoff syndrome varies. According to one study, about 25% of people with this disease can recover completely, 50% experience improvement, and the remaining 25% experience no improvement at all.

Wernicke-Korsakoff syndrome complications

If left untreated, Wernicke-Korsakoff syndrome can cause the following complications:

  • Injuries from falls resulting from impaired coordination, balance, or vision
  • Difficulty interacting with others
  • Disorders of thinking and memory functions that can be permanent
  • Permanent nerve damage ( neuropathy ) due to consumption of alcoholic beverages
  • Congestive heart failure
  • Relapse of Wernicke-Korsakoff syndrome

Prevention of Wernicke-Korsakoff Syndrome

The way to prevent Wernicke-Korsakoff syndrome is to not consume alcoholic beverages and increase consumption of foods or drinks that are rich in vitamin B1, such as:

  • Red rice
  • Wheat bread
  • Low fat meat
  • Sea food
  • Peas

If you are at risk of developing a thiamine deficiency, such as suffering from thyroid disease, kidney failure, or cancer, consult your doctor about the need for B vitamin supplements.

Back to blog