Wet Brain: Understanding Wernicke-Korsakoff Syndrome

Alcohol can be pleasant to take in moderation, but the adverse effects of excessive consumption are well-known and heavily studied. Drinking too much can cause a wide variety of health conditions, such as liver cirrhosis, pancreatitis, heart problems, malnutrition, and kidney disease. Moreover, it also negatively affects one of the body’s most important organs: the brain.

One well-studied brain disorder that has ties with excessive alcohol consumption is Wernicke-Korsakoff syndrome (WKS), which some people refer to as “wet brain.” Although this condition is reversible when treated in its early stages, it may progressively worsen if left unchecked. In this article, we will explore more about this illness, as well as its causes, signs, symptoms, and progression.

What Is Wet Brain: Wernicke-Korsakoff Syndrome?

Wernicke-Korsakoff syndrome, or “wet brain,” is a chronic and life-threatening brain disorder that can progressively worsen over time. It affects the lower regions of the brain known as the thalamus and hypothalamus. It’s a serious condition that can lead to permanent brain damage and a variety of distressing signs and symptoms.

Wet brain is prevalent among 1–2% of the general population, but excessive alcohol drinkers are more at risk. Those who chronically consume the substance are at much higher risk, with 12–14% of them developing the disorder. In fact, it got its name because it’s a common complication brought by years of alcohol abuse.

Wet brain actually is a combination of two conditions: Wernicke’s encephalopathy and Korsakoff syndrome (KS). The former is a more short-term neurological ailment, and its symptoms are typically the first ones to appear. On the other hand, the latter is a more chronic illness that progresses when Wernicke’s encephalopathy is left untreated. We will explore the two disorders below.

What Is Wernicke’s Encephalopathy, and What Are the Symptoms?

Wernicke’s encephalopathy (WE) is one of the two major components of Wernicke-Korsakoff Syndrome or wet brain. As mentioned above, it is a short-term neurological disorder that develops first.

The symptoms of Wernicke’s encephalopathy typically come in a triad: ataxia (loss of coordination and balance), confusion, and ophthalmoplegia (paralysis or weakness of the eye muscles). Approximately 10% of patients with this disorder show all three symptoms, and many other signs can also be present. 

Those who have WE may show apathy, clumsiness, vision disturbances, drooping eyelids, involuntary eye movements, and difficulty following objects with their eyes. Patients may walk with a stagger or may not be able to walk on their own.

Patients with WE do not have to show all three of the main symptoms to have the disorder, and the condition often goes undiagnosed because physicians were looking for all three markers. Thankfully, WE is reversible. Healthcare professionals need to take a more holistic evaluation of the patient to identify the illness and administer treatment right away before it progresses into the more chronic Korsakoff syndrome.

What Is Korsakoff Syndrome, and What Are the Symptoms?

Alcoholic Korsakoff syndrome or Korsakoff psychosis is a severe, chronic condition that affects around 10–90% of patients who abuse alcohol. It often happens when Wernicke’s encephalopathy remains untreated, and it can lead to continuous brain degeneration.

Korsakoff syndrome is also referred to as “alcohol amnestic disorder” or “alcohol dementia” because it exhibits indications of neuropsychiatric dementia. The signs and symptoms of this illness include hallucinations, apathy, amnesia, gaps in memories, lack of insight, and minimal input in conversations. They often show up as the symptoms of Wernicke encephalopathy start to fade.

wernicke korsakoff
Wernicke Korsakoff syndrome

It’s usual for people with Korsakoff psychosis to carry on a conversation coherently then forget that the exchange happened a few minutes afterward. They may also forget things that have happened in the past (retrograde amnesia) or experience difficulty forming new memories (anterograde amnesia). Patients may not even realize that they have symptoms of this disorder.

When the signs and symptoms of Wernicke’s encephalopathy and Korsakoff’s psychosis go together, then the patient has Wernicke-Korsakoff syndrome. They will likely experience long-term physical and mental decline, and when left untreated, may progress to coma or even death.

What Causes Wernicke-Korsakoff Syndrome or Wet Brain?

Wet brain occurs due to the lack of thiamine, or vitamin B1. This nutrient is essential for many bodily functions, such as turning food into energy, creating chemical messengers in the brain, and making helpful enzymes. As an essential vitamin, we can only get it through our diets. Without it, we risk developing problems with our brains, nerves, and hearts.

Vitamin B1 deficiency is relatively rare in developed countries, but it can occur due to malnutrition and various health conditions, such as HIV/AIDS, cancers, heart failure, and long-term dialysis. Excessive alcohol consumption is the leading cause of thiamine deficiency, and consequently, Wernicke-Korsakoff syndrome in the US.

People who drink alcohol excessively are prone to malnutrition and vitamin B1 deficiency because they often do not eat a healthy, balanced diet and only consume low levels of the said nutrient.

Thiamine must pass through the digestive tract and become processed and transported to different tissues that need the nutrient. Alcohol consumption causes inflammation of these passageways, leading to less efficient absorption of the vitamin. This malabsorption can also lead to deficiency.

How Is Wet Brain Diagnosed?

Diagnosing wet brain can be challenging because there is no one test that determines whether a person has the disorder. However, doctors can conduct a series of checks to obtain a clear overview of the patient.

Physicians may check patients for signs of alcoholism by checking blood alcohol levels or testing liver functions. They may also conduct physical exams to assess their eye movements, reflexes, blood pressure, heart rate, and body temperature. 

Doctors will also assess if a patient shows signs of a nutritional deficiency by running blood tests that check for thiamine levels and albumin. They may also request CT or MRI scans to check for any changes or abnormalities in the brain.

Is Wernicke-Korsakoff Syndrome a Treatable Condition?

Although Wernicke’s encephalopathy is reversible, it’s rare for people with Wernicke-Korsakoff syndrome to make a full recovery once Korsakoff’s psychosis sets in. Patients who begin treatment earlier have better outlooks than those whose conditions have already worsened.

Doctors primarily treat wet brain by giving the patients thiamine to mitigate the symptoms associated with Wernicke’s encephalopathy. These medications may come in the form of oral supplements or injections, which can help return the nutrient levels to normal. Although they can reduce confusion and memory problems while improving concentration and coordination, they may not do much about the long-term problems of Korsakoff psychosis.

Some physicians may also prescribe a balanced diet to help the patient maintain healthy levels of thiamine in the body. However, an equally crucial form of treatment would be to deal with the alcohol addiction that may have caused the deficiency in the first place. Seeking the help of professionals in alcohol and drug rehabs may be ideal.

Seek Help with Your Alcohol Addiction

Wernicke-Korsakoff syndrome or wet brain is a serious, life-threatening condition that should not be taken lightly. It’s one of the many negative consequences of alcohol addiction, and it can be terrifying to deal with. Although it’s treatable to some extent, seeking help before the condition worsens will be the best thing to do.

Sources:

https://medlineplus.gov/ency/article/000771.htm

https://www.ninds.nih.gov/Disorders/All-Disorders/Wernicke-Korsakoff-Syndrome-Information-Page