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Wernicke-Korsakoff Syndrome

Overview

This ia a brain disorder characterised by a loss of specific brain functions. This can be due to thiamine deficiency. Wernicke-Korsakoff syndrome usually affects people between the ages of 40 to 80. The onset of the condition is gradual. The disorder actually consists of two disorders that may occur independently or together - the disease may involve damage to multiple nerves in both the central nervous system (that is, brain and spinal cord) and the peripheral nervous system (that is, the rest of the body). It may also include symptoms caused by alcohol withdrawal.


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Causes

The cause is generally attributed to malnutrition, especially lack of vitamin B-1 (thiamine), which commonly accompanies habitual alcohol use or alcoholism. Wernicke's disease involves impairment of memory and intellect or cognitive skills such as problem solving or learning, along with multiple symptoms of nerve damage. The most distinguishing symptom is confabulation or fabrication, where the person makes up detailed, believable stories about experiences or situations to cover the gaps in his or her memory. The disease involves damage to areas of the brain.


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Signs & Symptoms

The following symptoms can be seen: 

  • Changes in vision
  • Uncontrollable twitching of the eyes, eye movement, drooping eyelids. 
  • Loss of muscle coordination, unsteady and uncoordinated walking, dysfunctional movement.
  • Muscle contractions and atrophy; hand tremour and facial paralysis.
  • Changes in sensation-decreased sensation in the feet or hands, numbness and tingling.
  • Thin, malnourished appearance with loss of hair and dry skin
  • Difficulty in swallowing; speech impairment -hoarseness or changes in voice.
  • Changes in mood, emotions and behaviour.
  • Memory loss and confabulation
  • Decrease in intellect and cognitive skills like problem solving and loss of ability to think abstractly.
  • Autonomic disturbances including orthostatic dizziness, constipation and inability to tolerate cold environment.
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Prevention

Minimal or moderate alcohol use and adequate nutrition reduce the risk of developing Wernicke-Korsakoff syndrome.


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Treatments
Thiamine Replacement therapy Modern Medicine

WKS can be prevented and treated if detected early. This consists of thiamine replacement therapy, sometimes given with other vitamins. If alcoholic consumption is stopped and treatment is administered properly, individuals with early-stage WKS can be treated and can be capable of learning simple, repetitive tasks.
The person’s confusion may take some time to subside, even incomplete recovery of memory can take up to a year. In the later stages, if damage to the brain is permanent, individuals are likely to have problems with memory and gait (for example, lack of muscle coordination and numbness or weakness in limbs).

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