alcoholic effects on the brain encephalopathy

Wernicke Korsakoff Syndrome – What happens when you heavily drink?

LaVona Tomberlin End of Life Issues, Life Transitions, Senior Living Tips

What happens when you drink heavily?

Wernicke-Korsakoff Syndrome is a serious issue for our parents who heavily imbibe now or were heavy drinkers earlier in their life. Basically Wernicke can level out but it does not completely go away.  Korsakoff is the second part of a two part syndrome and it changes the gait of their walk and weakens them to the point that they are very wobbly and unstable while standing.  This is when alcohol effects have really taken the body and this part rarely goes away.  The syndrome together is the effect of alcohol damage to the brain and is terminal.
Drinking alone does not cause it.  Excessive drinking over a prolonged time is the cause.

Wernicke-Korsakoff Syndrome (WKS) is one name for 2 conditions that often happen together.
Wernicke is encephalopathy and it is often accompanied by Korsakoff syndrome. It is thought to be different stages of the same disease.

A deficit of vitamin B1 or thiamine is the culprit. Thiamine or vitamin B1 helps the brain turn sugar to energy. When there is a deficit of this vitamin the brain does not function well. It typically comes on suddenly and immediate treatment is needed. Symptoms include confusion, loss of muscle coordination, and trouble with vision. Korsakoff syndrome happens slowly. It is a long term, ongoing problem that damages the part of the brain that handles memory. WKS is typically associated with chronic alcoholism. Alcohol use inhibits thiamine absorption, and heavy drinkers normally have poor dietary habits. It may have hereditary aspects as well but the most common presentation is a chronic alcoholic patient who is poorly nourished.

Changes that occur may be subtle but knowing of them can help you recognize them:

 Lethargy
 Drowsiness
 Inattentiveness/indifference
 Mental confusion
 Vision problems
 Muscle weakness
 Muscle coordination issues, especially walking/gait
 Tremor
 Recent or short-term memory difficulties
 Exaggerated storytelling
 Agitation

More acute symptoms that may indicate the need for more immediate medical attention include rapid heartbeat, low blood pressure, low body temperature, hallucinations, delirium, or stupor. Schedule an appointment if any of these symptoms are apparent and make sure that the family member has an advocate with them.

Since alcoholism is, many times, an ism that is not shared with even those closest to the person experiencing it, it is essential that the truth is provided to the physician in order for the alcoholic to receive the proper care. Honesty will, quite possibly, be the difference in whether help is received and can save the person’s life. Withholding information can only make matters worse and result in shortening that person’s life.

Wernicke-Korsakoff Syndrome Place for Mom Portland California Brain images

Diagnosis of Wernicke-Korsakoff syndrome requires a full medical history, including information regarding the person’s daily drinking habits, both past and present, and their dietary nutritional history. A physical examination to determine signs of malnutrition, lab work including blood count, electrolytes, and liver function tests. Test results can reflect alcoholism associated malnutrition or determine the level of thiamine. An MRI or CT scan may show enlarged ventricles and diencephalic lesions, shrunken mammillary bodies, and other changes to the brain. A referral by the psychiatrist or neurologist to a neuropsychologist is often necessary to quantify the degree of memory and other cognitive dysfunction and clarify the diagnosis. Physicians should consult family, friends, and past medical records to get the most complete information possible on the person’s history with alcohol.


Treatment is critical and time sensitive. What happens when you drink? Wernicke-Korsakoff Syndrome for those who drink.If diagnosed and treated early, some or sometimes all symptoms can be reversed. Once it becomes chronic recovery is less certain. Stopping alcohol use and ensuring a nutritious diet may prevent additional brain and nerve damage. Memory function can be slow to improve and recovery is usually incomplete. In later stages, damage to the brain is more likely to be irreversible and individuals will most likely have lasting problems with memory and gait which can be presented as lack of muscle coordination and numbness or weakness in limbs. Without treatment Wernicke’s encephalopathy can be incapacitating and life-threatening causing death in 20% of patients. In 85% of survivors, it progresses to Korsakoff syndrome. If patient continues to use alcohol and follow a poor diet the condition and symptoms will worsen.


Thiamine replacement therapy administered as soon as possible. Implementing consistent, good
hydration and nutrition while abstaining from alcohol is the key.



Look forward to Golden Placement new blog post on how to deal with someone with Wernicke Korsakoff Syndrome

Read more from LaVona: Golden Placements Life Transitions: Alcoholism and Aging

Here are more resources to help you learn more regarding Alcoholism and Aging and this Life Transition:

LaVona Tomberlin, Senior Placement Specialist

LaVona TomberlinLaVona is a Senior Placement Specialist at GPS. She loves writing about improving the lives of Elderly working in private care and in-home care for over 36 years. Geriatrics, Memory Care. Plus holds Master of Psychology Behavioral Health with the goal of advocating for those who needed a voice. Helping the families to make good decisions and to relieve their stress in uncertain times makes life worthwhile.