Part of the complete guide to understanding addiction
Wernicke-Korsakoff syndrome (WKS), commonly referred to as "wet brain," is a neurological disorder caused by a severe deficiency of thiamine. Thiamine, also known as Vitamin B1, is essential for proper heart, muscle and brain function and is typically obtained through proper diet. Vitamin B1 is necessary for your brain to turn carbohydrates, like sugar and starches, into energy. When your brain and nervous system do not receive an adequate amount of energy, they cannot function at healthy levels.
WK syndrome involves two distinct brain disorders, each with its own set of symptoms: Wernicke’s disease and Korsakoff’s psychosis. They often occur together. Wernicke's disease, also known as Wernicke’s encephalopathy, is the more severe phase of the disorder. It develops relatively quickly, and affected individuals require treatment. If people don’t receive timely treatment for Wernicke's disease, it can develop into Korsakoff's psychosis, a long-term condition. Unfortunately, over 80% of people who suffer from Wernicke’s syndrome will develop Korsakoff syndrome. Below we will look at the various symptoms that characterize these two brain disorders.
Causes of Wet Brain Syndrome
Although WKS isn’t exclusively associated with chronic alcohol misuse and severe alcohol use disorder (AUD), they are the most common causes of this disease. WKS occurs in only 1-2% of the general population, while an estimated 12-14% of alcoholics are likely to suffer from wet brain. Excessive alcohol consumption over a sustained period of time can lead to these two disorders for a number of reasons:
- Poor nutrition - The body does not produce thiamine on its own and typically obtains the vitamin through proper diet. Many foods are naturally rich sources of B1, including fish, meat, legumes, plus many fruits and vegetables. Thiamine can also be found in enriched food products, such as fortified breakfast cereals, breads and rice. Alcoholics tend to fill up on empty calories, resulting in poor nutrition and vitamin-weak diets. Alcohol has a high caloric value but is empty of vitamins or minerals. As a result, they don’t absorb the level of thiamine they need - a daily average of 1.1mg for women and 1.2mg for men. In addition, the high-calorie content of alcohol suppresses one’s appetite which leads to poor dietary habits, putting individuals at risk for thiamine deficiency alcoholism.
- Alcoholic gastroenteritis - Inflammation of the stomach lining can cause vomiting or diarrhea. This impairs the absorption of thiamine as it prevents nutrients from being absorbed into the gastrointestinal tract.
- Alcoholic liver disease – Alcoholic liver disease drastically reduces the thiamine storage capacity of the liver by as much as 73%.
Symptoms of Wernicke’s Disease
Neuropsychiatric symptoms of wet brain occur when levels of thiamine go below 20% of normal. The NIAAA explains that damage occurs in multiple brain regions, most notably the thalamus, hippocampus, hypothalamus, and cerebellum. Each of these areas controls different parts of the overall functioning of the body. The fact that they are all impacted has an adverse effect on many different parts of the body. The three primary symptoms of Wernicke’s syndrome are as follows:
- Confusion and disorientation: The affected person may have difficulty focusing, understanding their surroundings, and following conversations.
- Lack of muscle coordination: Also known as Ataxia, this affects coordination, posture, and balance, and can lead to tremors - involuntary movements in one or more parts of the body.
- Vision problems: Affected persons may experience vision problems, including abnormal eye movements (e.g., involuntary back-and-forth movements, called nystagmus), double vision, misaligned or crossed eyes, and eyelid drooping. Another condition is ophthalmoplegia, which is the weakness or paralysis of certain eye muscles. All of these can cause vision disturbances.
Symptoms of Wernicke's disease can develop relatively quickly, often within a matter of days to weeks. Although some symptoms of Wernicke’s disease, such as muscle and vision problems, are reversible with prompt thiamine treatment, other symptoms may respond more slowly or may not be completely reversible. Without prompt treatment, Wernicke’s disease can progress to Korsakoff’s psychosis, which is irreversible.
Symptoms of Korsakoff’s Syndrome
Korsakoff's syndrome is the chronic phase that may follow Wernicke's disease when it is left untreated or is treated insufficiently. Symptoms of KS are characterized by those listed above, as well as:
- Memory impairment: In the journal article Korsakoff’s syndrome: a critical review, the authors state that KS affects both “episodic memory, related to explicitly remembered personally experienced events specific to time and place, and semantic memory, related to facts.” Commonly referred to as alcoholic dementia, individuals may struggle to remember recent events and have difficulty forming new memories, though the anterograde memory processes (i.e., the capacity for new learning) are typically more severely affected than retrograde memory processes (i.e., those memories that existed before the onset of Korsakoff’s syndrome). In severe cases, this memory impairment can be irreversible.
- Problems with decision-making: Problems with decision-making are a direct offshoot of memory impairment, with individuals also experiencing difficulty planning, organizing, and completing tasks.
- Confabulation: Affected individuals may remember events incorrectly, and then to compensate for memory gaps, they will inadvertently invent inaccurate stories about events or "fill in" information with false details.
- Apathy and lack of insight: People with Korsakoff's syndrome may seem indifferent or uninterested and may not fully understand the extent of their memory deficits.
- Difficulty learning and retaining new information: Learning new concepts becomes challenging due to memory problems.
- Hallucinations: Individuals may see or hear things that are not really there.
- Repetitive speech and actions
Getting Help
While abstaining from alcohol use is critical to prevent and reduce additional brain damage at all stages of wet brain syndrome, the NIAAA explains that “when someone who has been drinking heavily for a prolonged period of time suddenly stops drinking, the body can go into a painful or even potentially life-threatening process of withdrawal.” Thus, individuals suffering from alcohol addiction should seek medical help where they can be guided on how to withdraw from it in a safe manner.
Is wet brain reversible? WKS is a serious medical condition that requires proper diagnosis and treatment. Some symptoms of wet brain may be reversible if detected early and treated with thiamine supplementation, whereby thiamine is administered intravenously. If the intervention is successful, individuals are able to regain some of their lost functionality. However, in advanced cases, the cognitive deficits may be permanent. Left untreated, WKS will prove fatal in an estimated 20% of cases, while approximately 75% of wet brain patients will suffer permanent brain damage.
It's crucial to seek medical attention if you suspect someone may be experiencing Wernicke-Korsakoff syndrome or any other medical condition. Early diagnosis and intervention can make a significant difference in the outcome and quality of life for the affected individual. If you or a loved one are experiencing difficulty with alcohol addiction, don’t hesitate to contact Avenues Recovery, where we can lead you on the road to recovery. Avenues Recovery treatment plans are individually designed for every patient because every person looking for help with addiction rehab is unique. Whether you require supervised detox treatment, inpatient programming, or outpatient therapy and counseling, Avenues is here for only one reason. We want to give you the best chance of success.