What Is Wernicke-Korsakoff Syndrome?

Wernicke-Korsakoff syndrome is a set of neurological conditions that result from a thiamine (vitamin B1) deficiency. When someone is deficient in thiamine, his brain is less able to process sugar into energy that the brain can use to function and he may develop symptoms of dementia including confusion and memory loss.

Wernicke-Korsakoff syndrome consists of Wernicke encephalopathy, which develops first, and then Korsakoff syndrome, which often presents as the symptoms of Wernicke encephalopathy are subsiding.

Wernicke-Korsakoff syndrome may also be referred to as Korsakoff psychosis, Wernicke's encephalopathy, alcoholic encephalopathy, encephalopathy - alcoholic and Wernicke's disease.


  • Wernicke Encephalopathy

Symptoms of Wernicke encephalopathy include a sudden episode of decreased mental ability, confusion, leg tremors, staggering, decreased muscle coordination, vision and eye changes (including eyelid drooping, double vision and abnormal back and forth eye movements) and other symptoms of alcohol withdrawal. Wernicke encephalopathy symptoms are often categorized as a triad of ocular (eye), cerebellar (balance and body control) and confusion symptoms.

Wernicke encephalopathy is a condition that requires immediate medical attention and with appropriate treatment, can be reversible.

  • Korsakoff Syndrome

Symptoms of Korsakoff syndrome consist of memory loss (including the ability to retrieve old memories and the ability to form new ones), hallucinations, and confabulation (making up stories).

Korsakoff syndrome is usually a chronic condition that typically, but not always, follows an episode of Wernicke's encephalopathy. 


It's difficult to know how common Wernicke-Korsakoff syndrome is, as research indicates that it is significantly under-diagnosed. One study references the rate as about 1-2 percent of the general population and 12-14 percent in those who abuse alcohol.

However, its diagnosis is frequently missed as evidenced by a higher identification of the disorder in brain autopsies than in life.


The most common risk for Wermicke-Korsakoff syndrome is alcohol abuse, but it can also be triggered by AIDS, cancer, chronic infections, kidney dialysis, anorexia and the inability of the body to absorb nutrients from food. The risk is also increased after bariatric surgery for obesity.


In order to diagnose Wernicke encephalopathy, thiamine levels in the person's blood should be tested.

There is no one test for Wernicke-Korsakoff syndrome. Instead, it is diagnosed by ruling out other conditions. Evaluation may include cognitive assessments, blood tests, and neurological screenings to evaluate eye movement, muscle strength and coordination. MRIs may also be used to identify the lesions in the brain that may develop as a result of the disease.


Wernicke encephalopathy requires immediate treatment which usually consists of high doses of thiamine given intravenously.

Some research indicates that when Wermicke encephalopathy is due to alcohol misuse, the person may require a higher dosage of thiamine than when it develops from other causes.

Ongoing treatment for Wernicke-Korsakoff syndrome includes abstinence from alcohol, adequate nutrition and vitamin supplementation.


The prognosis for Wernicke-Korsakoff syndrome is varied. With appropriate treatment, the Alzheimer's Association estimates that approximately 25% of people will recover, about half will improve but not fully regain full functioning and about 25% will remain about the same.

Any improvement in functioning usually occurs within the first two years after the symptoms began. Life expectancy may remain normal if the person does not drink alcohol.

The prognosis of Wernicke-Korsakoff syndrome is superior when compared to that of Alzheimer's disease and other types of dementia whose declines are chronic and progressive, despite attempts of treatment.


Alcohol & Alcoholism. Vol. 44, No. 2, pp. 148–154, 2009. The Korsakoff Syndrome: Clinical Aspects, Psychology and Treatment. http://alcalc.oxfordjournals.org/content/44/2/148.full.pdf

Alzheimer's Association. Korsakoff Syndrome. Accessed May 26, 2014. http://www.alz.org/dementia/wernicke-korsakoff-syndrome-symptoms.asp

Alzheimer's Association. Korsakoff Syndrome Topic Sheet. 2012. http://www.alz.org/dementia/downloads/topicsheet_korsakoff.pdf

Alzheimer's Society. What Is Korsakoff's Syndrome? May 2012. http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=98

European Journal of Neurology 2010,17:1408–1418. EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. http://www.efns.org/fileadmin/user_upload/CME_articles/CME_article_2010_December.pdf

National Institutes of Health.MedlinePlus. Wernicke-Korsakoff syndrome. February 24, 2014. http://www.nlm.nih.gov/medlineplus/ency/article/000771.htm

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