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What Is Wernicke-Korsakoff Syndrome (Wet Brain)?

Written by Rob Alston

& Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS, CACP

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Medically Reviewed by Conor Sheehy, PharmD, BCPS, CACP

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Updated 01/04/2022

Wernicke-Korsakoff Syndrome is caused by malnutrition when someone does not get enough thiamin in their diet. A leading cause is alcoholism.

Wernicke-Korsakoff Syndrome (WKS) is a condition that happens when someone is deficient in vitamin B1 (thiamin). Thiamin is critical for the functioning of brain cells because it helps them to produce energy. WKS is a combination of two different conditions: Wernicke’s encephalopathy and Korsakoff syndrome.

The condition is most common in people with severe malnutrition associated with alcoholism, AIDS and gastrointestinal disorders.

Why Is It Also Called Wet Brain?

WKS is called “wet brain syndrome” because the condition is common in people who abuse alcohol.

Alcoholics are deficient in thiamin for a couple of different reasons. The first is that they tend to have poor diets without much nutritional value. They may favor easy, cheap and fatty meals that are low in thiamin and other B vitamins.

The second reason is that even if alcoholics have a well-rounded diet, alcohol changes the functioning of cells in the intestines. Intestinal cells have proteins on their surface whose job it is to absorb thiamin. Alcohol causes cells of the gut to make less of this protein. So even if they eat a diet high in thiamin, it may not absorb properly, leading to WKS.

Since WKS is two different conditions that happen together, it is helpful to understand each separately.

Wernicke’s Encephalopathy (WE)

Thiamin deficiency causes Wernicke’s encephalopathy. It is a medical emergency, and the earlier it is recognized, the better the outcome will be. Symptoms may be hard to distinguish from alcohol intoxication, but they can show up even when someone is sober or experiencing alcohol withdrawal. Key symptoms include confusion, loss of muscle coordination (they may suddenly have trouble walking) and abnormal eye movements.

Korsakoff Syndrome (KS)

Also known as Korsakoff psychosis, this syndrome develops as WE subsides. KS is the result of permanent brain damage from thiamin deficiency, and symptoms remain long-term. Even if WE is caught early and treated, symptoms of Korsakoff Syndrome may still develop.

Alcohol Abuse & Wernicke-Korsakoff Syndrome

While WKS can manifest in anyone with severe malnutrition, alcoholics are especially susceptible. If WKS is not caught and treated, symptoms may worsen and eventually lead to death. The conditions can be slowed and stopped with treatment, but some symptoms of Korsakoff Syndrome may be permanent.

To help prevent WKS, a prevent who abuses alcohol may take thiamin supplements, but this not does completely erase the risk. Alcohol directly inhibits the absorption of thiamin in the gut, so even if an alcoholic diligently takes thiamin supplements, it may not absorb properly.

Symptoms Of Wernicke-Korsakoff Syndrome

Wernicke’s encephalopathy has three key symptoms. The symptoms are:

  • Abnormal eye movements like nystagmus (back and forth movements), double vision or eyelid drooping
  • Ataxia, or lack of voluntary muscle coordination
  • Confusion and loss of mental activity

Korsakoff’s syndrome shows up after the symptoms of WE go away. KS is permanent, and its symptoms range in severity based on each individual. Some examples of symptoms may include:

  • Confabulation (making up stories)
  • Hallucinations (seeing or hearing things that are not there)
  • Memory loss
  • Problems forming new memories

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Wernicke-Korsakoff Syndrome Treatment

WKS is treated with thiamin supplementation in the hospital. Thiamin can be given by mouth or as an injection in the muscle (intramuscular) or vein (intravascular). Since alcoholics may not absorb thiamin taken orally, most of the time they receive an injection.

The only guaranteed method to prevent WKS is to maintain a healthy diet, which in this case means quitting alcohol or reducing consumption.

If you or a loved one is drinking heavily over long periods, your risk of developing WKS is higher than normal. WKS is preventable, and the best way to prevent it is to stop drinking alcohol. If you need help drinking less or quitting entirely, please call The Recovery Village Palm Beach at Baptist Health to explore treatment options and to receive the help you deserve.

View Sources

Medline Plus. “Wernicke-Korsakoff Syndrome.” 2016. Accessed October 4, 2019.

Donnelly, Alexander. “Wernicke-Korsakoff Syndrome: Recognition and Treatment.” Nursing Standard, 2017. Accessed October 4, 2019.