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Per the 2015 National Survey on Drug Use and Health (NSDUH), 15.1 million adults 18 years of age or older – the equivalent of 6.2 percent of this age bracket – had an alcohol use disorder. This included 9.8 million men and 5.3 million women. Those who suffer from alcohol use disorder put themselves at risk for medical issues ranging from sexual dysfunction to liver damage to nutritional deficits. In some cases, the nutritional deficits cause long-term consequences, such as a condition known as wet brain.
What Is Wet Brain?Wet brain is a form of brain damage that results from repeat and heavy exposure to alcohol. Also known as Wernicke-Korsakoff syndrome, wet brain stems from a thiamine (vitamin B1) deficiency. Thiamine is an essential vitamin in the body that doesn’t occur naturally. A person must ingest it to achieve their daily recommended amount. The amount of thiamine in a person’s system diminishes as a result of a poor diet, which oftentimes occurs in people who regularly abuse alcohol.
In addition, alcohol hinders a person’s absorption of thiamine, and it diminishes the reserve of thiamine that’s stored in the liver. Alcohol also interferes with the enzyme that changes thiamine into an active state.
All tissue throughout the body requires thiamine. Several enzymes in the brain need thiamine to develop and function, and some of the enzymes that need thiamine are crucial in the synthesis of neurotransmitters in the brain. As a person repeatedly abuses alcohol and thiamine deficiency continues, brain damage begins. The National Institute on Alcoholism and Alcohol abuse declares thiamine deficiency as a rare occurrence in developed countries other than in people with an alcohol abuse issue or conditions like HIV.
Wernicke-Korsakoff syndrome consists of two individual syndromes: Wernicke’s encephalopathy and Korsakoff’s psychosis. Wernicke’s encephalopathy is a condition that causes neurological symptoms as a result of biochemical lesions of the nervous system. It most commonly affects specific portions of the brain, including the thalamus and hypothalamus, which play a role in memory. Korsakoff’s psychosis is a long-lasting condition that tends to develop after the Wernicke’s encephalopathy symptoms go away. Korsakoff’s psychosis arises as a result of permanent damage to the parts of the brain responsible for memory.
Wernicke’s encephalopathy causes various symptoms, such as:
- Loss of mental activity that can lead to a coma or death
- Loss of muscle coordination (ataxia) that may lead to a slow or unsteady gait
- Memory issues
Some people experience changes in vision, such as abnormal, back-and-forth eye movements. They may have double vision, or their eyelids may droop. When Korsakoff’s psychosis arises, people may lose the ability to develop new memories, and they may experience severe memory loss. Both visual and auditory hallucinations may occur. Some people who have Korsakoff’s syndrome may make up stories, oftentimes to fill the gaps in their memories..
The National Institute on Alcohol Abuse and Alcoholism indicates that approximately 80-90 percent of those who suffer from alcoholism and have Wernicke’s encephalopathy develop Korsakoff’s psychosis as well.
Currently, there’s not an exact count as to how many people have Wernicke-Korsakoff as a result of alcoholism since some people who have the condition are homeless or end up not seeking out medical care. The disorder is more common in men than women. The age bracket affected includes those between 30 and 70 years old.
Who Is Most at Risk?
The National Institute on Alcohol Abuse and Alcoholism reveals the amount of brain damage experienced from alcohol exposure directly relates to how much and how frequently a person drinks. The age the person started drinking along with how long the person has been drinking plays a role as well. Gender and age factor in as well.
Genetics can impact if, and how much, brain damage occurs due to alcoholism. Those who have a family history of alcoholism are more at risk for wet brain, and those who were exposed to alcohol while in the womb have a greater chance of developing Wernicke-Korsakoff syndrome. A person’s overall health will impact whether or not they will develop wet brain.
How Is Wet Brain Diagnosed?
There isn’t specific diagnostic testing used in all cases of wet brain. Generally, a practitioner will suspect a vitamin deficiency based on the patient’s physical appearance, gait, and behaviors. If a doctor is aware of an alcohol problem and the person exhibits symptoms of wet brain, further testing may be conducted.
Since there isn’t a standardized test to diagnose the condition, the doctor will conduct a thorough examination of the neurological system. The physician exams the eyes to determine any issues with eye movement, such as the eyes moving back and forth and misalignment of the pupils. The physician will also the person’s reflexes, as those with the condition have abnormal or decreased reflexes.
Those with wet brain tend to have decreased muscle mass and muscle weakness. This is due to the fact that thiamine is involved with the development of muscle tissue. The condition alters a person’s gait, so the doctor evaluates how the person walks. Oftentimes, those who have the disease have a rapid heart rate known as tachycardia. Blood pressure and body temperature slow since the disease affects the part of the brain responsible for controlling these functions.
Sometimes, it’s possible for a doctor to look at a person and see signs of malnutrition, but generally, the doctor will conduct certain tests to determine vitamin deficiencies. Through blood testing, a doctor may test a person’s serum albumin, which evaluates the person’s general nutrition. The doctor specifically tests the person’s thiamine level. Those who have thiamine deficiency have reduced activity in the red blood cells, more specifically with transketolase activity. Testing a person’s liver enzymes helps doctors determine the person has an alcohol problem.
The National Organization on Rare Disease states computed tomography (CT) and magnetic resonance imaging (MRI) are sometimes used to rule out the possibility of other issues, such as infarcts, bleeding in the brain, and tumors. These scans aren’t used to diagnose wet brain solely though, but doctors can discover changes in the brain that have occurred as a result of Wernicke-Korsakoff syndrome.
What Is the Prognosis for People with Wet Brain?
Statistics denoted by Merck Manuals indicate the mortality rate of people who have Wernicke’s encephalopathy is 10-20 percent. Of the people who survive, 80 percent will develop Korsakoff’s psychosis. Without treatment, the condition gets worse and can cause coma or death.
Wernicke-Korsakoff syndrome isn’t curable; however, with treatment, doctors are able to slow or stop the progression, states MedlinePlus. Treatments can help with certain aspects of the condition, but some problems like memory loss aren’t always reversible once it progresses. Early detection does have the potential to reduce damage and reverse some of it; therefore, those who suspect they may have the condition should seek treatment as soon as possible to minimize the amount of brain damage done.
How Is Wet Brain Treated?
Generally, a doctor will prescribe medications to control symptoms, such as rapid eye movements. The doctor will advise the patient on ways to increase levels of thiamine and may prescribe a vitamin supplement to increase levels. The person may receive vitamin B1 through an oral medication or by intravenous or intramuscular injections.
The supplemental thiamine may improve the symptoms of confusion or delirium. It also can impact the person’s issues with vision and eye movement, and improve a lack of muscle coordination. However, vitamin B1 will not improve the intellect or memory of people who have Wernicke-Korsakoff syndrome.
People with wet brain need to seek treatment for their alcohol use disorder if they haven’t already in order to stop or slow the progression of the disorder.
What Complications Can Occur from Wet Brain?
In addition to the potential for death or coma, Wernicke-Korsakoff syndrome leads to permanent damage to the brain, which affects a person’s memory and thinking skills. A person may have difficulty with social and person interactions. The loss of coordination and issues with gait associated with the disorder can lead to injuries.
Those who have the condition can develop permanent alcohol neuropathy, which affects the nervous system. People with Wernicke-Korsakoff syndrome tend to have decreased lifespans.