Wernicke-Korsakoff syndrome is a brain disorder involving loss of specific brain functions caused by a thiamine deficiency.

Wernicke's encephalopathy involves damage to multiple nerves in both the central nervous system (brain and spinal cord) and the peripheral nervous system (the rest of the body).

It may also include symptoms caused by alcohol withdrawal. The cause is generally attributed to malnutrition, especially lack of vitamin B1 (thiamine), which is common in those with alcoholism.

Heavy alcohol use interferes with the break down of thiamine in the body, so even if someone with alcoholism follows a well-balanced diet, most of the thiamine is not absorbed.

Korsakoff syndrome, or Korsakoff psychosis, tends to develop as Wernicke's symptoms do away. This involves damage to areas of the brain involved with memory. Patients often attempt to hide their poor memory by creating detailed, believable stories about experiences or situations. This is not usually a deliberate attempt to deceive because the patient often believes what he is saying to be true.

• Vision changes
  • Double vision
  • Eye movement abnormalities
  • Eyelid drooping
• Loss of muscle coordination
  • Unsteady, uncoordinated walking
• Loss of memory, can be profound
• Inability to form new memories
• Confabulation (making up stories)
• Hallucinations

Examination of the nervous/muscular system may show damage to multiple nerve systems. Reflexes may be decreased or abnormal. The person's walk (gait) and coordination will be tested. Muscles may be weak and may show atrophy (loss of tissue mass).

Examination of the eyes shows abnormalities of eye movement.Blood pressure and body temperature measurement may be low. Pulse (heart rate) may be rapid.

The person may appear malnourished. The following tests are used to check a person's nutrition level and may confirm malnourished state.

• Serum B1 levels may be low.
• Pyruvate is high.
• Transketolase activity is decreased.

Blood or urine alcohol levels and liver enzymes may be high if the person has a history of chronic (long-term) alcohol abuse.

Other chronic conditions that may cause thiamine deficiency include:

• AIDS
• Hyperemesis gravidarum (continuous nausea and vomiting during pregnancy)
• Thyrotoxicosis (very high thyroid hormone levels)
• Cancers that have spread throughout the body
• Long-term dialysis
• Congestive heart failure, when treated with long-term diuretic therapy

A brain MRI rarely shows changes in the tissue of the brain indicating Wernicke-Korsakoff syndrome.