Korsakoff Syndrome

Korsakoff syndrome is a dementia-like disease that affects the brain that is often caused by the excessive abuse of alcohol for a prolonged period. Alcohol impedes the body’s ability to produce vitamin B1 (thiamine) because alcohol contains sulfites, which break apart thiamine’s chemical structure and make absorption impossible.

Thiamine increases the brain’s ability to synthesize energy from the body’s sugars (carbohydrates). A lack of thiamine means the brain cannot produce enough energy to generate new memories and learn new skills. Other common results include fatigue, weakness, psychosis, and, eventually, nerve damage.

This terrible condition is most common among alcoholic males who are over age forty. While science cannot precisely explain why alcohol causes Korsakoff disease, the causal association between the two has been well-established through research. Another problematic condition known as Wernicke’s encephalopathy (described below) often, but not always, precipitates Korsakoff syndrome.

Recovery statistics following a diagnosis of Korsakoff syndrome are as follows:

  • 25% of sufferers make a full recovery
  • 50% make a partial recovery but require assisted living for the remainder of their lives
  • The remaining 25% of sufferers, unfortunately, experience little or no improvement and therefore need institutional living

Symptoms of Korsakoff Syndrome

Korsakoff syndrome (also known as Korsakoff psychosis) damages the heart, blood vessels, and nervous system. This condition is the cognitive deterioration that manifests itself as dementia in late-stage alcoholics through the following symptoms and impairments:

  • Disorientation
  • Delirium (confusion and hallucinations)
  • Attention deficits
  • Inability to learn new skills
  • Memory loss
  • Confabulation

Memory impairments can come in the form of retrograde amnesia (recalling details from the past) or anterograde amnesia (obtaining recent information). Confabulation is a term that means a person attempts to fill in missing memories with fabricated or “borrowed experiences,” but believes them to be genuine recollections. It very unhelpful in these instances to accuse the sufferer of lying, as he or she will truly believe what they say.

People with this disease are often easily frustrated, agitated, and aggressive. At other times they may appear dazed or in a trance-like state. Normal daily activities such as walking, grasping objects, eating, drinking, and grooming become very difficult.

While a Korsakoff patient suffers from a virtually non-existent short-term memory and confusion, patients can still discuss past events or experiences in detail.


Korsakoff syndrome is a clinical diagnosis that reflects a physician’s best judgment about the etiology of a person’s symptoms. There are no specific neuroimaging procedures or lab tests that will confirm a person has this condition. The syndrome can be hard to identify because it may be masked by symptoms of other conditions common among those who abuse alcohol, including intoxication, withdrawal, infection, or head injury.

Experts recommend that a medical assessment for memory loss or other cognitive changes should always include questions about an individual’s alcohol use.

Wernicke’s Encephalopathy

Encephalopathy is a medical term that means “disease of the brain.” In this case, the injury involves a myriad of nerves in the brain and spinal cord and nerve endings throughout the body.

Wernicke’s encephalopathy symptoms may include:

  • Vision impairment
  • Sluggish pupil reflexes and uneven pupil size
  • Involuntary eye movement (nystagmus)
  • Eye paralysis (ophthalmoplegia)
  • Mental confusion or stupor
  • Loss of coordination (ataxia)
  • Low body temperature (hypothermia)
  • Low blood pressure (hypotension)

Without treatment, Wernicke’s encephalopathy develops into Korsakoff psychosis or results in coma and death.

Some researchers posit that Wernicke and Korsakoff syndromes are separate but closely related disorders. Others believe, however, that they are essentially different stages of one disorder, or acute and chronic components of the same disease, respectively. Wernicke’s encephalopathy and Korsakoff’s psychosis are the acute and chronic phases, respectively, of the same disease.

Treatment for Korsakoff’s Syndrome and Addiction

Korsakoff’s Syndrome

Korsakoff’s syndrome can be treated and sometimes yield positive results. To counteract this deficiency, a doctor will often inject raw thiamine into the body of the person suffering from Korsakoff syndrome. Since the disease primarily impacts short-term memory, those memories relating to the period before the development of the condition are usually left intact.

Treatment may also consist of thiamine supplements, adequate nutrition, hydration, and long-term abstinence from alcohol. Most signs of the deficiency are reversible if caught early.

For some, however, the return of memory and cognitive function falls somewhere between irregular and absent altogether. Some alcoholics experience permanent brain damage and require assistance with basic daily living activities (custodial care) due to lack of treatment.


Those who suffer from alcoholism put themselves at risk for a host of medical conditions and nutritional deficits. In some cases, the nutritional deficiencies from chronic alcoholism have long-term consequences, such as Korsakoff’s psychosis and Wernicke’s encephalopathy.

Alcoholism is a chronic disease that is not curable but treatable. Our center uses an integrated approach to addiction that includes research-based therapeutic services such as psychotherapy, psychoeducation, group support, and individual and family counseling.

These services are delivered by compassionate addiction professionals who provide clients with the resources and knowledge they need to recover and experience long-lasting wellness and sobriety.

Coping with addiction is a life-long process, but you don’t have to do it alone. Call us today and discover how we can help you achieve the life you deserve!

Related: Liver Pain After Drinking Alcohol?

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