‘Wet Brain’: Wernicke-Korsakoff Syndrome

One of the saddest sights for any of us to see is someone who is staggering along the street, apparently drunk and out of control.  We worry that person might fall and injure themselves and we fear for our own safety because, clearly, this person has had a lot to drink. What many people do not realize is that the behavior of this individual is not from just a few drinks at the pub. It could be a sign of an acute alcohol-related condition known as “wet brain,” also identified as Wernicke-Korsakoff syndrome. It is important to diagnose this as early as possible. Some of the symptoms make it seem like the person is simply intoxicated — uncoordinated movements, confusion, forgetting what happened in the moment before, and eyes drooping — it is not always easily discovered. One study discovered that up to 80% of the people with this syndrome are not formally diagnosed or treated and it is not discovered until there is a death and ensuing autopsy. At least 20% of patients lose their lives to this syndrome and 75% may find themselves with permanent brain damage. What Is Wet Brain?  It is actually two specific conditions, named after the two doctors who discovered them. Combined, they are diagnosed as wet brain.

  1. Wernicke’s encephalopathy (WE). This is an acute neuropsychiatric that is reportedly caused by problems with the brain metabolism that is created by severe depletion of thiamine (vitamin B1). This vitamin depletion is overwhelmingly associated with alcohol disorder.
  2. Korsakoff’s psychosis (KP). This is brain damage that includes severe loss of short-term memory. This condition is closely associated with WE.

The collective of symptoms are often labeled as Wernicke-Korsakoff syndrome.

What Are the Symptoms?

Heavy alcohol consumption has its own dangerous side effects and some of these may be similar to wet brain in look and behavior. Wet brain is especially impacted by thiamine deficiency and compounded by inadequate dietary intake and impaired absorption of the vitamin. Each condition has its own recognizable symptoms.

Wernicke encephalopathy symptoms include:

  • Loss of mental acuity and confusion
  • Problems with muscle coordination
  • Leg tremors
  • Change in vision or drooping eyelid
  • Abnormal movement of the eyes

Korsakoff Syndrome symptoms include:

  • Confabulation of stories that did not happen
  • Auditory or visual hallucinations
  • Memory loss, short-term and in other ways

What Is Wet Brain Treatment?  Recovery depends on alcoholic neurotoxicity and the severity of thiamine deficiency, as well as personal susceptibility. In many cases, delayed discovery makes it too late to treat.  Restoring thiamine is part of the process but this will not solve or prevent psychological decline in all patients. MRI is a tool for identifying some affected areas of the brain and for tracking brain pathology. It can also be used to track progress from the acute phase and chart any resolution achieved with thiamine treatment Wet brain can lead to coma and death if not discovered and treated.  Sources: The Role of Thiamine Deficiency in Alcoholic Brain Disease Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy. Abnormality of a Thiamine-Requiring Enzyme in Patients with Wernicke-Korsakoff Syndrome The Natural History and Pathophysiology of Wernicke’s Enchephalopathy and Korsakoff’s Psychosis Wernicke-Korsakoff syndrome. Neuroimaging of the Wernicke–Korsakoff Syndrome  

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