To fathom the utter devastation of Korsakoff’s syndrome, all one needs to do is read “Tuesday,” a play that was written in the 1990s. In it, the main character suffers from this rare condition, which produces amnesia brought on by prolonged alcohol abuse.

Korsakoff’s syndrome causes him to lose his entire life story. According to the site of playwright Paul Mullin, the character forgets “everything he knows about himself every time he falls asleep.” Every morning he wakes up, “he must be painstakingly re-taught every detail of his existence.” 

Korsakoff’s syndrome (or Korsakoff’s psychosis) occurs in 1 to 2 percent of the general population of the U.S., but it is more common in people with alcohol use disorder (AUD). Why? Besides the extensive damage prolonged drinking does to the heart and liver, it also impacts the brain and the body’s ability to absorb thiamine (vitamin B1).

For people with an extensive history of alcohol addiction, a professional treatment program can offer the care and therapy necessary to halt the bodily damage caused by drinking.  

Read on to learn more about the devastating effects of Korsakoff’s syndrome and its associated condition, Wernicke encephalopathy.

What is Korsakoff’s Syndrome (And Wernicke Encephalopathy)?

To fully understand the extent of Korsakoff’s syndrome (also known as alcoholic Korsakoff syndrome or AKS), one must first learn about its relationship to Wernicke encephalopathy (WE). The two conditions are often associated with each other as Wernicke-Korsakoff syndrome (WKS), which is also referred to as alcohol dementia.

Though they are associated with each other, the two conditions were discovered separately.

Sergei Korsakoff, a Russian psychiatrist, studied patients who grappled with alcoholism for a lengthy period in the late 1800s. What he noticed among them was a steep decline in memory function. At a medical conference in Moscow in 1897, he presented a report titled, “On a special form of mental illness combined with degenerative polyneuritis.” That presentation led to the condition being coined in his name: “Korsakoff’s Syndrome.” 

German neurologist Carl Wernicke described acute encephalopathy as a series of symptoms involving mental confusion and involuntary eye movements among other symptoms. 

The two conditions ended up being placed under one name because they occur due to the same cause: thiamine deficiency.  

Wernicke-Korsakoff Syndrome (WKS)

Alcohol itself does not cause Korsakoff’s syndrome or Wernicke encephalopathy. However, heavy alcohol consumption can hinder the body’s ability to properly absorb food. Thus, chronic drinking can reduce the body’s ability to absorb thiamine, which is an essential nutrient. This deficiency can lead to WKS. 

How essential is thiamine?

Thiamine is vital in that it cannot be synthesized by the body and is a cofactor in enzymes required for the system to produce energy aerobically

For every 1,000 calories consumed, about 0.33 milligrams (mg) is used under normal circumstances, according to a report published in Psychiatric News.  If this proportion is ever interrupted due to a lack of thiamine, metabolic systems in the body are at risk of slowing or shutting down. 

If the neurons located in the central nervous system (CNS) do not get the opportunity to feed off thiamine due to a deficiency, particularly when the body lacks the nutrient between 10 to 14 days, neurons can die. 

Also, the deficiency is exacerbated because people who have alcohol use disorder (AUD) tend to have poor dietary habits that are heavy with fatty food consumption. 

WKS Symptoms

The two conditions can occur independently or together, but Korsakoff’s syndrome usually develops after Wernicke symptoms begin to ease or stop altogether, according to Verywell Mind.

Both conditions can produce symptoms that can result in brain damage. Specifically, WE causes damage to the thalamus and hypothalamus, and Korsakoff’s psychosis occurs from permanent impairment to the memory areas of the brain. 

These symptoms can result from Wernicke encephalopathy:

  • Alcohol withdrawal
  • Vision changes such as abnormal eye movements (back and forth movements called nystagmus), double vision, eyelid drooping
  • Confusion and loss of mental activity that can progress to coma and death
  • Loss of muscle coordination that results in leg tremor

The symptoms of Korsakoff’s syndrome include:

  • Hallucinations
  • Making up stories (confabulation)
  • Inability to form new memories
  • Potentially severe loss of memory

When Alcohol Use Disorder (AUD) is Present

If you are concerned that you or a loved one may be exhibiting symptoms of alcoholism, official criteria exist for you to determine whether an alcohol use disorder (AUD) is present.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) — the principal authority on psychiatric diagnoses — sets forth 11 criteria to determine whether someone has a problem with alcohol. 

If a person has met two of the 11 criteria over a 12-month period, an AUD is present. The severity of that AUD can be mild, moderate, or severe. That conclusion is based on the number of criteria a person meets

To determine whether you or a loved one has AUD, here are some questions to ask. In the past year, have you or that person: 

  • Had times when you ended up drinking more, or longer than you intended?
  • More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
  • Spent a lot of time drinking? Or being sick or getting over the aftereffects?
  • Experienced craving — a strong need, or urge, to drink?
  • Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
  • Continued to drink even though it was causing trouble with your family or friends?
  • Given up or cut back on activities that were important or interesting to you, or gave you pleasure, to drink?
  • More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
  • Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
  • Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
  • Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

If you or a loved one exhibits any of those symptoms, drinking may already be a problem. The more symptoms you or a loved one displays, the more urgent the issue.  

Why Professional Treatment is Vital

As one of the most dangerous substances in existence, alcohol, when abused, can profoundly damage the body and the brain — as evidenced by the presence of Wernicke-Korsakoff syndrome. 

Alcohol abuse can cause stroke, high blood pressure and cirrhosis of the liver. It can also lead to pancreatitis, which is inflammation and swelling of the blood vessels in the pancreas. There is also substantial evidence that points to a causal relationship between alcohol consumption and several types of cancers, including head and neck, esophageal, liver, breast, and colorectal cancer.

What’s more, excessive alcohol use can compromise your immune system to such a degree that the body becomes susceptible to illnesses like pneumonia and tuberculosis.

How Professional Addiction Treatment Can Help You

A professional recovery program can halt the cycle of alcohol addiction and its many ravages. 

A rehab program can treat the life-threatening symptoms of alcohol withdrawal. The process begins with medical detoxification, where distressing withdrawal symptoms such as seizures, shakiness, agitation, tremors, nausea, and vomiting are alleviated while the alcohol is removed from the body. 

Detox stabilizes the body, but the counseling and therapy offered through professional treatment are designed to heal the psychological wounds of the addiction itself. It accomplishes this by allowing clients to comprehend the underlying causes of their alcohol addiction.

You can be connected to a supportive recovery community such as 12-step, which has been proven to help clients with AUD remain sober. 

Ultimately, professional treatment can help you before disastrous conditions like Korsakoff’s syndrome set in.

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