Wernicke encephalopathy or Wernicke-Korsakoff encephalopathy and Wernicke-Korsakoff syndrome is an unusual type of memory disorder due to a lack of thiamin (vitamin B1) requiring immediate treatment.
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It most often happens in people with alcohol use disorder and malnutrition. It happens due to a severe lack of thiamine (vitamin B1), which causes damage to the brain. Thiamine is an essential vitamin that our body uses to convert food into energy.
Stages:
- Wernicke encephalopathy, a sudden and severe (acute) brain disorder
- Korsakoff syndrome, a long-term (chronic) memory disorder.
How are Wernicke encephalopathy and Korsakoff syndrome related?
Untreated Wernicke encephalopathy develops into Korsakoff syndrome. Commonly, patients with Wernicke encephalopathy have three main symptoms:
- Confusion.
- Inability to coordinate voluntary movements (also known as ataxia).
- Visual changes and additional eye problems.
- Muscle loss.
When these symptoms become long term, they cause lasting brain and nerve cell damage. This causes severe memory loss and the inability to form new memories, leading to Korsakoff syndrome.
Over time, Wernicke-Korsakoff syndrome worsens and can be life-threatening. Emergency treatment with thiamine is essential. Thiamine could just relieve the symptoms and prevent permanent damage to memory and other brain functions.
Who does Wernicke-Korsakoff encephalopathy affect?
Wernicke-Korsakoff encephalopathy e affects more men than women, usually between ages 30 and 70 years. Most alcohol-related cases of Wernicke-Korsakoff encephalopathy involve men and those over age 40. Women and people who are younger are more likely to develop the syndrome due to other causes (aside from alcohol).
Wernicke encephalopathy develops most often in people with alcohol use disorder. Long-term (chronic) alcohol use irritates stomach and digestive tract. It also interferes with body’s ability to absorb vitamins (malabsorption).
Wernicke-Korsakoff encephalopathy also happens in people who can’t properly absorb food due to certain conditions. It may develop after weight loss (bariatric) surgery or as a side effect of chemotherapy.
Other risk factors include:
- Bowel or stomach problems, including inflammatory bowel disease or stomach disease (gastropathy).
- Cancer (advanced stages).
- Extremely high thyroid hormone levels (thyrotoxicosis).
- Having certain genetic changes (mutations).
- Heart failure that’s treated with diuretic therapy for a prolonged period.
- HIV/AIDS, which can lead to conditions that lessen thiamine.
- Kidney failure, as long-term dialysis reduces your body’s ability to absorb thiamine.
- Vomiting and extreme nausea in pregnancy (hyperemesis gravidarum).
Causes
Causes of Wernicke-Korsakoff syndrome include:
- Poor nutrition.
- Eating disorders.
- Chronic infections.
- Surgery, including weight loss (bariatric) procedures such as gastric bypass surgery.
- Head injury (traumatic brain injury).
Symptoms and of Wernicke-Korsakoff encephalopathy
Wernicke-Korsakoff encephalopathy can cause a wide range of symptoms. One symptom in people with severe disease is confabulation, where they invent information to cover memory loss.
People with the syndrome may also be confused or disoriented. The confusion makes it difficult for them to realize anything is wrong and seek treatment.
Some common signs of Wernicke encephalopathy may include:
- Balance problems or loss of coordination.
- Confabulation.
- Confusion (delirium).
- Difficulty walking (unsteady gait).
- Drowsiness.
- Extreme loss of body heat (hypothermia).
- Heart issues, including rapid heartbeat (tachycardia) or low blood pressure (hypotension).
- Lack of muscle coordination (ataxia).
Eye issues are also common, including:
- Abnormal eye movement (nystagmus).
- Double vision.
- Drooping eyelid (ptosis).
- Eye muscle paralysis or weakness (ophthalmoplegia).
Wernicke Korsakoff syndrome
Left untreated, Wernicke encephalopathy can lead to Wernicke Korsakoff syndrome, a chronic memory disorder. Symptoms include:
- Amnesia or inability to form new memories.
- Behavioral changes, such as agitation or anger.
- Confabulation.
- Delirium and disorientation.
- Fatigue or lethargy.
- Hallucinations, especially in those withdrawing from alcohol.
- Lack of focus or attention.
- Unsteady gait.
Diagnosis
Ask your patient about his/her symptoms and family history. Diagnosing Wernicke-Korsakoff encephalopathy can be difficult when patient is experiencing mental confusion or memory loss.
It’s important for the doctor to check for symptoms of:
- Alcohol use disorder.
- Malnutrition.
- Thiamine deficiency.
Tests required are:
- Arterial blood gas (ABG) test to measure carbon dioxide and oxygen levels in blood.
- Complete blood count (CBC).
- Toxicology (drug) screening.
- check blood sugar and thiamine levels.
- blood alcohol test.
- LFTs.
Imaging tests:
- CT scan.
- MRI.
- Electrocardiogram (EKG).
Allopathic treatment and management for Wernicke encephalopathy
While there isn’t a cure in allopathic medicines for Wernicke-Korsakoff encephalopathy. Healthcare providers can recommend treatments to manage symptoms only.
In many cases, allopathic treatment just can slow or reverse symptoms such as confusion, eye problems and muscle coordination.
Treatment for Wernicke-Korsakoff syndrome depends on patient’s symptoms and usually involves:
- Vitamin B1 tablets or injection.
- IV fluids (rehydration).
- Alcohol use disorder treatment.
- Nutritional support.
Homeopathic treatment for Wernicke encephalopathy
Homeopathic treatment of Wernicke encephalopathy varies with the primary cause of the symptoms and thus design a treatment plan to reduce or eliminate the cause(s), for example:
Short-term and/or long-term anoxia, hypoxemia (less than two minutes):
Aspidosperma, China Officianalis, Ferrum Metallicum. Vanadium Metallicum, Coca, Calceria Carbonicum, Gelsemium, Carbo vegetabilis, Arnica montana, Conium Maculatum etc.
Alcoholism (short term or addicted):
Arsenicum Album, Helleborus Niger, Viscum Album, Medorrhinum, Aethusa cynapium, Cannabis indica, Ignatia Amara, Nux Moschata etc.
Uremic encephalopathy (due to kidney failure):
For kidney disease and failure please visit these websites “Click Her for websites, Calculus and Failure.
Diabetic encephalopathy:
For diabetic encephalopathy treatment please Click Here.
Hypo- or hypertensive encephalopathy:
For the treatment of hypotensive and/or hypertensive encephalopathy please Click Here.
For infectious encephalopathy please Click Here, here (liver), Here (flesh/muscles etc) and for viral Here and Here.
For Viral encephalopathy please Click Here (zika) and Here (virus) and Here (cancers and tumors).
Encephalopathy due to brain/nervous system diseases Click Here (meningitis), Here (dementia), Here (seizure), Here (Alzheimer’s disease), Here (lethargy) etc.
Prognosis (outlook) for encephalopathy
The prognosis for a patient with Wernicke encephalopathy depends on the initial causes and, in general, the length of time it takes to reverse, stop, or inhibit those causes. With Homeopathic treatment, the prognosis varies from patient to patient, but all they recover; While with allopathic treatment prognosis is very poor, it often leads to permanent brain damage or death.
P. S: This article is only for doctors having good knowledge about Homeopathy and allopathy, for learning purpose(s).
For proper consultation and treatment, please visit our clinic.
None of above-mentioned medicine(s) is/are the full/complete treatment, but just hints for treatment; every patient has his/her own constitutional medicine.
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Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS), Abdominal Surgeries, Oncological surgeries, Gastroenterologist, Specialist Homeopathic Medicines.
Senior research officer at Dnepropetrovsk state medical academy Ukraine.
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