2023-06-22 13:01:35
Alcohol is one of the leading causes of preventable death. Globally, nearly 3 million people die of it every year, around 40,000 in France – and that’s not counting the social consequences linked to its consumption. Most people with alcoholic relatives are traumatized in some way and sadly familiar with the havoc this addiction can wreak. However, it is far from being an evil to be underestimated, since 10% of the French population would consume alcohol on a daily basis.
Among its terrible consequences, alcohol can cause forms of dementia: this is particularly the case with what is called Wernicke-Korsakoff syndrome. If all the organs suffer from excessive alcohol consumption – starting with the liver, it goes without saying – there is one that is particularly affected – and yet it is the most precious: our brain. It is precisely to him that this syndrome attacks. And the results are not pretty to see: it is undoubtedly one of the worst forms of dementia linked to alcohol consumption, with cognitive disorders affecting mobility and balance as well as memory. Alcohol is thus one of the main causes of so-called early dementia, that is to say before the age of 65. Here’s everything you need to know regarding Wernicke-Korsakoff syndrome, and how to recognize it.
Wernicke-Korsakoff syndrome: what is it?
Wernicke-Korsakoff syndrome is what is called alcoholic dementia. It was in fact at the end of the 19th century that it was diagnosed by the Russian neuropsychiatrist whose name it bears, Korsakoff, and it designates the most severe form of cognitive disorders encountered in chronic alcoholics — although that other health problems may be involved, since it is actually a vitamin deficiency that is the cause.
In fact, it is therefore a complex neurological condition that results from a deficiency in vitamin B1, also known as thiamine. This disease thus mainly affects the central nervous system – and is therefore often associated with alcoholism, excessive consumption of alcohol. It is the thalamus and the hypothalamus, as well as the middle zone of the brain, which are affected. It is a neurodegenerative disease, but it is potentially reversible – hence the importance of properly identifying it in order to be able to treat it in time. Due to its occurrence particularly related to alcohol consumption, this disorder has also been known by other names. Earlier, it was called Korsakoff’s psychosis, or simply alcoholic neurocognitive disorder.
The causes of Wernicke-Korsakoff syndrome
As we have mentioned, on the physiological level, the syndrome results from a deficiency in thiamine, which is more commonly known as vitamin B1. Vitamins are those nutrients that are essential to the body’s survival and which the body cannot synthesize on its own — they must therefore be supplemented through food. With regard to vitamin B1, it plays an essential role in the proper functioning of the nervous system, and is thus essential for the proper functioning of memory and intellectual faculties. To put it simply, thiamin helps to help the body synthesize glucose (i.e. sugar) in order to provide the energy needed for proper brain function. It is therefore understood that a deficiency in vitamin B1 leads to dementia. It is thus found in foods such as cereals, nuts, dried beans, meat.
Regarding the origin of this deficiency, it is above all a question of poor diet – and this is in fact generally found in people in a state of chronic alcoholism. It is otherwise very rare to be malnourished to such a severe degree. Not only does alcoholism affect the lifestyle of sufferers to the point of affecting their diet, but the amounts of alcohol consumed interfere with the body’s absorption, storage and use of thiamine. . However, it should be noted that other health problems can be the cause of a vitamin B1 deficiency.
For social reasons, it is mainly men aged 45 to 65 who are affected by this syndrome: it is at this age that alcoholism most often takes this turn among them. On the other hand, it is interesting to note that the women affected are younger, around the age of 35, due to the fact that they are more vulnerable than men to the consequences of alcohol.
Symptoms of Wernicke-Korsakoff Syndrome
As its name suggests, this alcoholic dementia is characterized by two distinct but often interconnected conditions: one is Wernicke’s encephalopathy and the other is Korsakoff’s syndrome. The former was first described in 1881 and the latter in 1889, but it was in 1897 that a common cause was first suggested to them, which would not be identified until the 1930s — namely a deficiency in thiamin therefore, which explains their often joint occurrence.
You guessed it, in the absence of thiamine, the brain and nervous system can no longer play their role properly. They therefore undergo increasingly severe alterations, which can be distinguished between a first phase, more acute, and a second, chronic one. The first, Wernicke’s phase, is characterized by symptoms such as motor coordination disorders, blurred or double vision, mental confusion, muscle weakness, loss of appetite… People affected by this phase may also have problems with balance and walking, which can make them unsteady and prone to falls.
Korsakoff’s syndrome, on the other hand, is manifested by memory problems, difficulty learning new information, confabulations (involuntary fabrication of memories to fill memory gaps, or thinking to recognize and communicate in a seemingly coherent way with a unknown person) and temporal disorientation. People with this syndrome may also exhibit personality changes, such as emotional apathy or indifference. With regard to memory, if the patient can in some cases remember his distant past, recent events are completely forgotten, like Alzheimer’s disease or what happened a few minutes earlier is already forgotten — this is called anterograde amnesia.
While Wernicke’s encephalopathy is an acute phase and therefore occurs suddenly — it can even be fatal — Korsakoff’s syndrome develops over the long term. It usually develops following Wernicke’s encephalopathy, hence the combination of the two pathologies into one, but can also occur independently. This is why Wernicke’s encephalopathy must be treated quickly when it occurs, in order to guard once morest Korsakoff’s syndrome.
Treating Wernicke-Korsakoff Syndrome
To establish the diagnosis, it is necessary to stop the consumption of alcohol. Indeed, another neurological disease may also be involved. However, the symptoms tend to stabilize with withdrawal when alcoholic dementia is responsible. The diagnosis can unfortunately be slowed down, on the one hand because the characteristic symptoms of Wernicke’s encephalopathy do not always appear simultaneously, on the other hand because some patients may be reluctant to admit their alcoholism.
Treatment for Wernicke-Korsakoff syndrome relies primarily on vitamin B1 supplementation to correct the deficiency. In severe cases, thiamine can be administered intravenously to ensure rapid and efficient absorption.
In addition to vitamin B1 supplementation, people with Wernicke-Korsakoff syndrome often benefit from multidisciplinary care. This can include rehabilitation sessions to improve motor coordination and balance, as well as cognitive rehabilitation programs to help address memory and learning issues.
It is evident that stopping alcohol consumption is a crucial step in the treatment and prevention of Wernicke-Korsakoff syndrome in people with alcoholism. Reducing alcohol intake or abstaining completely allows the body to better absorb thiamine and avoid deficiencies that can worsen symptoms. It should however be noted that one does not wean oneself off such an addiction just like that. Remember that alcohol is one of the few drugs whose sudden withdrawal can have fatal consequences. Hence the importance once more of being cared for in a multidisciplinary framework, and within a specialized establishment. In addition to thiamine administration and alcohol withdrawal, care is taken to ensure that the patient is well hydrated and has a balanced diet.
Once affected by this syndrome, the brain damage is unfortunately irreversible for some. This is why it is essential to avoid reaching this stage. All that can be expected from the treatment is the stabilization of the patient’s condition. Treated in time, it is nevertheless possible to recover a more or less important part of the affected functions. This can take up to a year, and it is of course necessary to remain abstinent following the treatment — otherwise you risk further brain damage.
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