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Wet Brain from Alcohol: Signs & Symptoms of Wernicke-Korsakoff Syndrome

Wet brain, or Wernicke-Korsakoff syndrome (WKS), is a brain disorder related to the acute and chronic phases of a vitamin B1 (thiamine) deficiency. Thiamine depletion is seen in individuals with poor nutrition and is a common complication of long-term heavy drinking. It’s possible to reverse the symptoms when caught early, but when left untreated, wet brain can lead to irreversible confusion, difficulty with muscle coordination, and even hallucinations.

Here, we’ll provide you with critical information on Wernicke-Korsakoff syndrome and its signs, symptoms, causes, and prognosis, as well as the recovery options available to those suffering from this condition. There are ways to prevent wet brain before it develops and it can be treated effectively if a doctor is seen soon after symptoms arise.

What Is Wet Brain?

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Wernicke-Korsakoff syndrome (WKS), also referred to casually as “wet brain” is a severe, life-threatening brain disorder that is actually comprised of two conditions.2

The first part of WKS, Wernicke’s encephalopathy, is a severe and temporary condition characterized by confusion, loss of muscular coordination, and abnormal eye movements and vision changes.

The second aspect of WKS, Korsakoff’s psychosis, often follows or accompanies Wernicke’s encephalopathy. Korsakoff’s psychosis is a persistent, chronic condition that can cause significant impairment in learning and memory and interfere with a person’s ability to function normally.1,3 The casual name for WKS, wet brain, was coined because the condition most commonly emerges as a consequence of several years spent abusing alcohol.1,3

The symptoms of WKS actually begin from a deficiency in thiamine that is typically associated with extended heavy alcohol use but may also be caused by malnutrition and other diseases.1,3 Up to 80% of people with severe alcohol use disorder become thiamine deficient.A person must be sober when demonstrating symptoms to be diagnosed with wet brain, considering that withdrawal, or medical complications associated with alcohol use can mimic symptoms of WKS.4

Although it is estimated that only 1-2% of the general population develop WKS, those who chronically drink are at a higher risk with prevalence rates estimated around 12-14%.2

How is Alcohol Abuse Connected to Wet Brain?

Thiamine (vitamin B1) is an essential nutrient utilized by all parts of the body which can only be obtained through diet.1,3 Thiamine deficiency can cause damage to the brain, nerves, and heart.3

In the United States, alcohol abuse is the leading cause of thiamine deficiency, and consequently the development of WKS. 3

Chronic alcohol abuse can lead to thiamine deficiency through poor nutrition and malabsorption.2, 5 For example, people who drink heavily often do not eat a balanced diet and do not take in sufficient levels of thiamine to meet their nutritional needs.3 Indeed, studies show that chronic drinkers consume lower levels of thiamine.3

For the body to absorb thiamine, it must pass through the gastrointestinal tract to be transported to the tissues of the body, and absorption is decreased in people with chronic alcohol abuse.3,4 Alcohol use can create inflammation in the digestive tract, which makes it far more difficult for the body to absorb thiamine.5 Heavy drinking can also make it difficult for the body to effectively process and utilize thiamine in the cells of the body.3,5 Thiamine is essential for building enzymes that play important roles in processing and converting sugar into energy and creating chemical messengers in the brain and genetic material in the cells.3,4,6

What are the Symptoms of Wet Brain?

The typical symptoms of WKS, or wet brain, can seem similar to those of intoxication. However, the symptoms of WKS persist in the absence of drinking.Some common symptoms of wet brain include:1,3,4

  • Loss of muscular coordination.
  • Abnormal eye movements.
  • Vision changes (e.g., double vision).
  • Memory loss.
  • Behavioral changes.

Family members may notice certain characteristics develop in a person with wet brain, such as: 1,4,5

  • Frustration and irritability.
  • Lies, or making up stories.
  • Difficulty and resistance.

In addition to the long-term physical and mental  deterioration, WKS can also lead to reduced consciousness, coma, or even death in some cases.3,6,7

Wernicke’s Encephalopathy

As mentioned, WKS is comprised of two characteristic parts. The first component of WKS is Wernicke’s encephalopathy (WE), which is a short-term neurological disorder.3,6 The three hallmark signs of WE include mental confusion and apathy, loss of muscular coordination while standing or walking,  and eye movement dysfunction and vision disturbances.1,3,6 The nerves that control the eyes may become paralyzed in people who suffer from WE, leading to involuntary eye movements, drooping eyelids, and difficulty tracking objects properly.3,6 Coordination issues can cause people with WE to walk with a stagger, and in severe cases, to lose the ability to walk.3,7

While there are three characteristics of WE, a person does not have to exhibit all three of these symptoms to have the disorder.1,7 Studies have shown that many cases of WE were undiagnosed because all three symptom types weren’t exhibited, making holistic evaluation of a patient even more critical.3 WE is caused by thiamine deficiency1,3 and is reversible, but treatment must be provided as quickly as possible to ensure  better treatment outcomes.7

Korsakoff Psychosis

Around 80% to 90% of people who abuse alcohol and have WE go on to develop Korsakoff’s psychosis, a form of neuropsychiatric dementia.3,7 Korsakoff’s psychosis is seen as a residual condition that results when WE isn’t treated quickly and effectively, resulting in a range of symptoms that can become detrimental to a person’s ability to function.5 This condition may also be referred to as “alcohol amnestic disorder” or “alcoholic dementia”.3

Characteristics of Korsakoff’s psychosis include amnesia, hallucinations, and changes in behavior.3,4,5 Memory issues may involve difficulty remembering past information (retrograde amnesia) and trouble forming new memories (anterograde amnesia), which can lead to confabulation, the formation of stories to make up for gaps in one’s memory.3,4,6,8

Memory issues associated with Korsakoff’s psychosis occur because the areas of the brain that control memory are damaged as a result of the disease.4 (symptoms) People with this disorder may not even realize that they have any symptoms and may show certain behavioral changes such as becoming apathetic, irritable, or displaying less emotion that normal.5

Is Wernicke Korsakoff Syndrome Reversible?

WKS is a potentially reversible condition.2,5,7 The severity of a person’s symptoms, how early a person begins treatment, and the type of treatment that they receive can all have a significant impact on whether a case of WKS can be reversed or alleviated.2,4

Some people may make a full recovery, although this is rare. Thiamine therapy will offer varying levels of improvement in symptoms after 5-12 days.6

How is Wet Brain Treated?

The primary way that physicians treat Wernicke Korsakoff Syndrome is through potent thiamine supplementation. Abstinence from alcohol will be beneficial while receiving treatment for WKS. 3,5,6 Since WKS is caused by thiamine deficiency, high dose thiamine supplementation proves to be one of the most effective treatments for the reversal or prevention of symptoms, especially in the early stages of WKS.1,5,6,7

Thiamine may be taken as an oral supplement or as an intramuscular or intravenous injection to restore a person’s normal thiamine levels to the body and reduce symptoms.5,7Additional vitamins or supplements can be provided as well, which can help the body to process thiamine and increase levels in the body.6,7 Increased thiamine levels have been shown to reduce confusion, increase coordination, improve eye function, and reduce memory problems in patients with WKS.3,6

Treatment for Alcohol Use Disorder and Alcohol Addiction

It is recommended that those with WKS abstain from alcohol, which may require treatment for an alcohol use disorder. This may slow the progression of their condition and improve chronic symptoms of WKS. 8 American Addiction Centers (AAC) offers a range of programs that treat alcohol addiction and help people get and stay sober across the United States. 

Our treatment programs provide comprehensive care starting with medical detox through treatment, with qualified staff available to assist you. AAC is so confident in their ability to help people stay sober that they offer a 90-day promise. If you relapse after 90 days of consecutive treatment at an AAC center, you can return for another 30 days of treatment at no additional cost.

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Last Updated on Nov 10, 2022
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