Wernicke-Korsakoff syndrome or Wernicke-Korsakoff syndrome (WKS) is a disorder of the brain caused by a deficiency (deficiency) of vitamin B1. This disorder is a combination of Wernicke's disease and Korsakoff's syndrome.
Wernicke's disease and Korsakoff's syndrome are two different conditions. However, the two conditions are interrelated and can appear gradually. Wernicke's disease generally occurs first, then Korsakoff's syndrome will occur if Wernicke's disease is not treated promptly.
Causes of Wernicke-Korsakoff Syndrome
The cause of Wernicke-Korsakoff syndrome is a deficiency of vitamin B1 or thiamine. Thiamine helps the brain and nervous system convert sugar into energy. Lack of this vitamin will interfere with the performance of the brain and nervous system, and cause brain damage, including the thalamus and hypothalamus.
Vitamin B1 deficiency is generally caused by alcoholism and malnutrition. Alcohol addiction is a major cause of thiamine deficiency because alcohol can decrease the body's ability to absorb and store this vitamin.
In addition to alcohol addiction, the following conditions can also increase the risk of thiamine deficiency, namely:
- Eating disorders, such as anorexia nervosa
- Gastrointestinal disorders, such as stomach cancer and colon cancer
- Kidney disorders requiring long-term hemodialysis (dialysis)
- Heart failure requiring long-term diuretic therapy
- Certain diseases, such as HIV/AIDS
- Vomiting that occurs continuously or pregnant women who suffer from hyperemesis gravidarum
- Bariatric surgery
Other conditions that make it difficult for a person to access healthy food, such as poverty and war, can also increase the risk of developing Wernicke-Korsakoff syndrome.
Wernicke-Korsakoff syndrome is more common in men, people aged 45-65 years, people who live alone, and people with mental disorders.
Symptoms of Wernicke-Korsakoff Syndrome
Symptoms of Wernicke-Korsakoff syndrome are preceded by Wernicke's disease or Wernicke's encephalopathy first. Wernicke's disease has 3 typical symptoms, namely:
- Disorders of the eye, such as diplopia (double or shadowed vision), ptosis (drooping of the eyelids), and nystagmus (rapid and uncontrollable eye movements)
- Coordination disorders, such as ataxia, weakness in the legs, difficulty standing and walking, and tremors
- Mental disorders and consciousness, such as confusion, confusion, and loss of consciousness
Wernicke's disease can also cause problems with the heart and blood vessels. It is characterized by the following conditions:
- Heart palpitations (palpitations)
- Low blood pressure (hypotension)
- Weakness or tiredness for unknown reasons
If Wernicke's disease is not treated immediately, it will progress to Korsakoff's syndrome. Korsakoff syndrome can be characterized by the following symptoms:
- Unable to remember events after this syndrome appeared (anterograde amnesia)
- Difficulty understanding information
- Difficulty in stringing words
- Experiencing hallucinations, such as hearing or seeing things that aren't really there
- Confabulation, which is making up an exaggerated story to complete the missing parts in memory
The symptoms of Korsakoff's syndrome usually appear after the symptoms of Wernicke's disease have subsided.
When to go to the doctor
Immediately consult a doctor if the symptoms of Wernicke-Korsakoff syndrome appear above. This is because the disorder needs to be treated as soon as possible to prevent complications and permanent damage to the brain.
People who are alcohol dependent or suffer from disorders that can inhibit nutrient absorption, such as anorexia and gastric cancer, are more likely to develop Wernicke-Korsakoff syndrome.
Therefore, if you experience these conditions, consult a doctor for treatment, so that Wernicke-Korsakoff syndrome can be prevented.
Diagnosis of Wernicke-Korsakoff Sindrom Syndrome
To diagnose Wernicke-Korsakoff syndrome, the doctor will ask the patient's complaints and symptoms, as well as his medical history.
Next, the doctor will perform a thorough physical examination, including examination of vital signs (temperature, heart rate, respiratory rate, blood pressure), examination of muscle strength, and examination of nerves.
To confirm Wernicke-Korsakoff syndrome, the doctor will perform the following investigations:
- Blood tests, to check the levels of thiamine and alcohol in the blood
- Electrocardiography (ECG), to measure the electrical activity of the heart before and after taking thiamine supplements
- CT scan or MRI, to check for brain damage from Wernicke-Korsakoff syndrome
Treatment of Wernicke-Korsakoff Syndrome
Treatment of Wernicke-Korsakoff syndrome aims to relieve symptoms, stop disease progression, and prevent complications.
Treatment of Wernicke-Korsakoff syndrome includes supplementation of vitamin B1 or thiamine and the regulation of a high-thiamine diet. The stages are as follows:
- Giving vitamin B1 supplements by injection
- Oral administration of vitamin B1 supplements
- Regulating a diet rich in vitamin B1
If his condition is so weak that he loses consciousness, the patient needs to get intensive care in a hospital so that his condition and body's response to treatment can be monitored.
If the patient's condition is stable, treatment can be continued on an outpatient basis. The duration of treatment can vary, it can even reach several months.
People with Wernicke-Korsakoff syndrome caused by alcohol addiction also need to get rehabilitation to stop alcohol addiction. If the patient has difficulty walking or has other physical problems, physiotherapy can be done.
The success rate of treatment for Wernicke-Korsakoff syndrome varies. According to a study, about 25% of patients with this disease can recover completely, 50% experience improvement, and the remaining 25% do not experience any improvement at all.
Complications of Wernicke-Korsakoff Syndrome
If you don't get treatment for Wernicke-Korsakoff syndrome, it can cause several complications, namely:
- Injuries due to falls due to impaired coordination, balance, or vision
- Difficulty interacting with other people
- Disorders of cognitive function (thinking function) and memory that are permanent
- Permanent nerve damage (neuropathy) due to alcohol consumption
- Congestive heart failure
- Relapse of Wernicke-Korsakoff syndrome later in life
Prevention of Wernicke-Korsakoff Sindrom Syndrome
The best way to prevent Wernicke-Korsakoff syndrome is to avoid alcohol and increase consumption of foods or drinks rich in vitamin B1, such as:
- Wheat bread
- Low fat meat
In people who are at risk for thiamine deficiency, vitamin B supplements may be needed to prevent Wernicke-Korsakoff syndrome.