Alcoholic Dementia and Wernicke-Korsakoff Syndrome

Alcoholic Dementia is a condition caused by excessive, long term alcohol consumption that results in problems with memory, learning and cognitive skills.

Korsakoff Syndrome is a chronic memory disorder caused by a severe deficiency of thiamine. Thiamine helps brain cells produce energy from sugar. When Thiamine levels fall too low, brain cells are not able to generate enough energy to function properly, as a result, Korsakoff Syndrome may develop. Though, Korsakoff Syndrome can be associated with other illnesses, it is most commonly caused by alcohol misuse.

Korsakoff syndrome is often, but not always, preceded by an episode of Wernicke Encephalopathy, and for that reason, the disorder is sometimes called Wernicke-Korsakoff Syndrome.

Wernicke encephalopathy is an acute brain reaction, to a severe lack of Thiamine. It is a medical emergency that causes life-threatening brain disruption, confusion, staggering and stumbling, lack of coordination, and abnormal involuntary eye movement. Unlike most other forms of Dementia, memory problems may be strikingly severe but the thinking and social skills most often remains intact.

Causes

According to Wikipedia, conditions that may result in thiamine deficiency include chronic alcoholism and severe malnutrition. Alcoholism may co-occur with poor nutrition, and combined with inflammation of the stomach lining, can produce a thiamine deficiency.

Other things that may lead to a thiamine deficiency include prolonged vomiting, eating disorders, mercury poisoning, and the effects of chemotherapy.

Effects

The effects of alcohol, once absorbed in the bloodstream, are most prominent within the brain and the liver. The job of the liver is to metabolize the alcohol, but excessive consumption, over a prolonged period, can lead to liver failure. Liver failure simply means that your liver is losing or has lost all its function. Liver failure is a life-threatening condition that demands urgent medical care.

The effects of alcohol on the brain, Wernicke-Korsakoff syndrome, also known as Wet Brain is a form of brain damage that results from heavy, chronic drinking. It develops due to a thiamine deficiency. Because thiamine is not a naturally occurring vitamin in the body, it must be ingested to maintain adequate levels in the body. It is probably safe to say that most people drinking excessively do not eat a well balance diet to provide and maintain adequate amounts of thiamine.

Signs and Symptoms

Wikipedia lists seven major symptoms of alcoholic Korsakoff syndrome:

• Memory loss for events after the onset of the syndrome (anterograde amnesia)

• Memory loss that extends back for some time before the onset of the syndrome (retrograde amnesia)

• Loss of immediate memory, not being able to remember the events of the past few minutes (fixation amnesia)

• Invention of stories to fill in the gap in memory, “tells honest lies”, where even the patients believe themselves (confabulation)

• Minimal content in conversation

• Lack of insight

• Apathy

Alcohol Induced Dementia

Generally, Dementia occurs in people age 65 and older, but according to cleanandsoberlive.com, alcohol Dementia is different. This illness can affect people as young as age 30. The symptoms are very similar to those symptoms which result from heavy drinking. Many drinkers, family members, and close friends are familiar with the confusion, poor judgment, gaps in memory, repetition in conversation, and personality changes that is exhibited by a person in a drunken state. For the person without Dementia, these symptoms will go away when he or she sobers-up, but for the person with Dementia, due to the permanent damage to brain cells, these symptoms are present even in the sober state.

Alcohol induced Dementia and Wernicke Korsakoff Syndrome are terms that are used interchangeably when discussing this condition. They are not the same, even though a person can have them both.

Some warning signs to look for in people that may be developing Dementia:

• Excess anger and irritability

• Paranoia and jealousy

• Mood swings

• Flat emotions and insensitivity to the feeling of others

• Fear of loneliness

• Confabulation

• Repetition in conversation

• Difficulty with problem solving related task, even familiar ones

• Indecisiveness

• Poor follow through on projects.

• Personality changes

• Hoarding

• Neglect

• Poor recognition of familiar people and places

Treatment for Alcoholism

If you feel like you must have a drink, or you can’t control how much you drink, or you have poor control of your emotions when not drinking, it may be time to seek treatment.

Alcohol causes changes in the brain. Webmd.com states, “alcohol use disorder is actually considered a brain disease. Some people may be able to stop drinking on their own. A larger percentage will require professional help. Some may require an aggressive inpatient program, while others may be able to handle it as outpatients. Having to deal with withdrawal symptoms may help to determine which program best suits the occasion. In an article from webmd.com suggests that you start with your doctor, discuss treatment options, go to detox, see a counselor or therapist, and for ongoing support, join a group. In some cases, medication maybe necessary to help with the disorder. Your doctor can help you to determine where you are and what is your best treatment option.

The goal is to STOP drinking, get the alcohol out of your system. For people who have severe alcohol use disorder this is no walk in the park. This, in most cases, can bring on severe withdrawal symptoms which may include:

• Full body tremors

• Hallucinations (seeing and feeling things that are not there.) A very popular one is seeing worms crawling on the walls, the ceiling, and can sometimes feel and see them crawling on their bodies.

• Seizures

For family members with no prior knowledge, withdrawal symptoms can be frightening. The individual experiencing the withdrawal symptoms, in most cases, will need help. A hospital or a treatment center, where the individual can be monitored and treated by experts, is highly recommended.

Treatment for Wernicke-Korsakoff Syndrome

The severe shortage of thiamine in the body mostly happens to people who are long term, heavy drinkers. When alcohol is involved, stopping drinking would be the obvious first step. With directions from your physician, your next step would be rapid replacement of thiamine. Recovery will depend largely on how early the treatment starts. Wernicke encephalopathy can often be reversed. In Korsakoff Syndrome the progression can be stopped but the damage that has already taken place cannot be reversed.

Sources

Jeanty, J. (2017). Retrieved from https://healthyliving.azcentral.com/alcohol-dementia-signs-symptoms-12155489.html

Alcohol Induced Dementia. (2019). Retrieved from https://www.cleanandsoberlive.com/alcohol-induced-dementia/

Treatment of Alcohol Abuse & Alcoholism. (2019). Retrieved from https://www.webmd.com/mental-health/addiction/alcohol-use-disorder-treatments#1

What Is Wernicke-Korsakoff Syndrome?. (2019). Retrieved from https://www.webmd.com/brain/wernicke-korsakoff-syndrome-facts#2

Wernicke–Korsakoff syndrome. (2019). Retrieved from https://en.wikipedia.org/wiki/Wernicke–Korsakoff_syndrome