Wernicke-Korsakoff syndrome

Definition

Wernicke-Korsakoff syndrome is a set of symptoms caused by Wernicke's Encephalopathy and Korsakoff's psychosis

Epidemiology

20% fatality rate.

Pathophysiology

The main cause is vitamin B1 (thiamine) deficiency, usually as a result of long-term alcohol misuse. It can be due to severe starvation or prolonged vomiting.

Risk Factors

Generally, the only real risk factor is long-term alcohol misuse.

Clinical Features

Medical Emergency - Wernicke's Encephalopathy is a medical emergency, signalled by new onset confusion, eye problems and ataxia, seen in an alcoholic.

Commonly seen symptoms, as a result of lack of thiamine are:

• Confusion
• Cerebellar dysfunction causing
  • Nystagmus
  • Ataxia
• Opthalmoplegia - IIIrd/VIth nerve damage

Investigations

Don't generally do a test, is diagnosed clinically.

Management

It needs treating immediately with IV thiamine!