If you’ve ever blacked out from drinking and couldn’t remember anything from the night before, know that the consequences of alcohol consumption can be much, much worse. Years of excess alcohol consumption can result in permanent memory loss. This condition is known as Wernicke-Korsakoff syndrome (WKS), a type of alcohol-related dementia that can be life-threatening if untreated. 

What is Wernicke-Korsakoff syndrome (WKS)?

Wernicke-Korsakoff syndrome is a neurological disorder characterized by symptoms of severe memory loss along with cognitive and motor function impairment. It’s fairly uncommon, in large part due to how preventable it is. Long-term alcohol abuse is the most common cause of Wernicke-Korsakoff syndrome, though it is not the only one, and is why WKS is also sometimes referred to less formally as “wet brain.” 

Cause of Wernicke-Korsakoff syndrome

The root cause of Wernicke-Korsakoff syndrome is a thiamine deficiency (thiamine is an essential nutrient, perhaps better known as Vitamin B1). Thiamine is crucial to cell growth and functioning — including brain cells. Sustained low thiamine levels will eventually cause the brain to atrophy; reduced brain volume in turn means the loss of the brain cells’ neural connections — pathways that are integral to carrying out even the most basic functions. This results in Wernicke-Korsakoff syndrome having symptoms very closely resembling that of dementia. 

How alcoholism increases risk of Wernicke-Korsakoff syndrome

Wernicke-Korsakoff syndrome is estimated to affect, at most, 2% of the global population. Individuals with alcohol addiction, however, are over five times more likely to develop WKS (12%) and comprise the majority of WKS cases. (Non-alcohol-related cases exist, but they’re exceedingly rare. For all intents and purposes, alcoholism is widely considered the cause of Wernicke-Korsakoff syndrome.)  

The strong link between alcohol and WKS stems from thiamine deficiency. Thiamine (B1) is an essential vitamin. It enables cells to convert food into energy. This process is crucial for healthy body and brain function. Thiamine is found in various common foods, including eggs, poultry, pork, fish, dairy, and whole grains. Due to the accessibility of these food sources, thiamine deficiencies are uncommon in areas with regular food access.

Alcohol can disrupt thiamine intake through two main mechanisms. First, it impairs digestive system function. This reduces the body’s ability to absorb minerals and nutrients from food. Second, excessive alcohol consumption contributes to malnutrition. Malnutrition is common among individuals with alcoholism. Alcohol can replace nutritious meals. This, combined with reduced vitamin absorption, further exacerbates the problem.

Therefore, alcohol does not directly cause low thiamine levels. However, the side effects of alcohol on the digestive system and its impact on eating habits significantly increase the risk of WKS.

Wernicke-Korsakoff syndrome symptoms

The characteristics of Wernicke-Korsakoff are caused by the degeneration of nerve cells in the brain, which are the same mechanisms that cause dementia. The symptoms a person will experience will vary depending on which stage of the disease a person is in.

WKS is comprised of two stages: an acute stage of sudden sensory and motor function impairments which is then followed by chronic memory loss. This syndrome is actually the combination of what was previously considered two separate psychiatric conditions. Now, Wernicke-Korsakoff syndrome is considered one single disorder. 

Stage 1: Wernicke encephalopathy

In the initial stage (Wernicke encephalopathy), the onset can be sudden and the symptoms severe, though it can potentially be reversed with proper and timely treatment. Symptoms are typically neurological, and include:

  • Ataxia (loss of muscle coordination)
  • Abnormal eye movements
  • Blurred or double vision
  • Confusion
  • Loss of balance
  • Muscle loss
  • Paralysis or weakness of eye muscles
  • Tremors

If unchecked, this condition could develop into the second and final stage of WKS, formally known as Korsakoff psychosis, which is permanent and is where the greatest risk of danger lies. Symptoms of the final stage of WKS can include:

  • Behavioral changes
  • Confabulation
  • Difficulty learning new things (anterograde amnesia)
  • Disorientation
  • Fatigue
  • Hallucinations
  • Inability to focus
  • Lethargy

Is there a cure for Wernicke-Korsakoff syndrome?

There is no cure for Wernicke-Korsakoff syndrome. Symptoms can be reversed if detected and treated early enough; however, even in this initial, less severe stage, the disorder can be deadly. One out of five people in Wernicke’s encephalopathy do not survive. The vast majority of those who do (85%) end up going on to develop the irreversible stage of the disorder. Once nerve damage (in the brain) is too severe, no amount of thiamine in the form of food, supplements, or injections will be enough to reverse the damage. The best way to protect yourself from alcohol memory loss is to get help before it’s too late. Find an alcohol rehab near you, today, 

Sources:

https://www.alzheimers.org.uk/about-dementia/types-dementia/alcohol-related-brain-damage-arbd

https://ods.od.nih.gov/factsheets/Thiamin-HealthProfessional

https://my.clevelandclinic.org/health/diseases/thiamine-deficiency#symptoms-and-causes