Wet Brain or Wernicke-Korsakoff Syndrome – Causes & Treatment

Wernicke-Korsakoff syndrome arises due to a deficiency of vitamin B1 (thiamine). It is classified as a neuropsychiatric disorder, also known as wet brain disease or wet brain syndrome since it typically occurs in individuals with alcohol use disorder.12, 13

What Is Wet Brain?

Wet brain is a medical condition that includes a combination of two related but different disorders: Kosakoff’s psychosis and Wernicke’s encephalopathy. According to some scientists, this is a single disorder that involves different stages, where Wernicke’s encephalopathy is the acute stage which can advance to Korsakoff’s psychosis, which is the more chronic form of wet brain.14

Wernicke-Korsakoff syndrome (WKS) occurs as a result of thiamine deficiency. While this deficiency can be caused by poor nutrition or intense vomiting periods, the most common cause is regular alcohol abuse. 14, 15

Individuals who drink heavily typically do not have a balanced diet and a sufficient intake of vitamin B1 to meet their daily nutritional needs. Studies have shown that chronic drinkers consume lower amounts of thiamine.15

Thiamine must go through the gastrointestinal tract in order for the body to absorb it and transport it to the tissues. This absorption is decreased in individuals with AUD. Chronic alcohol abuse can also cause inflammation of the digestive tract, making the absorption more difficult. It can also hinder the body’s ability to effectively process and use vitamin B1 in the cells.16,17,18

Wernicke-Korsakoff syndrome is a neuropsychiatric disorder that results from vitamin B1 (thiamine) deficiency.¹² It is colloquially referred to as the wet brain syndrome or wet brain disease as the majority of cases occur in patients suffering from alcohol use disorder.¹³

Wernicke’s encephalopathy

Wernicke’s encephalopathy (WE) is a short-term disorder. The crucial signs of WE include apathy and mental confusion, reduced muscle coordination while walking or standing, vision disturbances, and eye movement dysfunction. Eye-controlling nerves can become paralyzed and lead to drooping eyelids, difficulty tracking objects, and involuntary eye movements. Due to coordination problems, people may stagger while walking or even lose the ability to walk.  However, an individual does not necessarily exhibit all of the symptoms.16,19,20,21

Korsakoff’s psychosis

Korsakoff’s psychosis is a type of neuropsychiatric dementia, also known as alcoholic dementia or alcohol amnestic disorder. About 80% to 90% of individuals with AUD who have WE develop Korsakoff’s psychosis as well. It is a residual condition which occurs when WE is not treated promptly and effectively. It causes symptoms that can damage an individual’s ability to function.16,18,21

The symptoms of this disorder include changes in behavior, hallucinations, and amnesia. Issues with memory can include retrograde amnesia (difficulty remembering past information) and anterograde amnesia (difficulty forming new memories). This potentially causes confabulation, or making up for memory gaps by forming stories.16,17, 18,20, 21 

Memory issues occur because the disease damages brain areas that control memory. Individuals with Korsakoff’s psychosis may not notice having any symptoms and may show changes in behavior such as displaying less emotions than usual or being irritable or apathetic.17,18 

What Are the Symptoms of Wet Brain?

While the symptoms of wet brain and intoxication may seem similar, those of wet brain persist in the absence of drinking as well. The typical symptoms of WKS include:16,17,19 

• Abnormal eye movement.
• Loss of muscle coordination.
• Memory loss.
• Changes in vision (e.g. double vision).
• Changes in behavior.

The family members of an individual with wet brain main notice they develop certain characteristics, such as:17,18,19 

• Irritability and frustration.
• Lying or making up stories.
• Resistance and difficulty.

Apart from the long-term mental and physical deterioration, this disorder can also result in impaired consciousness, coma, or death. 16, 20, 21

Signs and Symptoms of Wet Brain

There is disagreement among researchers about whether Wernicke and Korsakoff syndromes are separate disorders or different stages of the same disorder, in the case of alcoholics, popularly referred to as alcoholic wet brain.²

Statistics show that around 80-90% of patients with Wernicke syndrome develop Korsakoff syndrome.² Wernicke syndrome is acute, while Korsakoff syndrome is chronic.⁴

Wernicke’s Encephalopathy

Wernicke’s encephalopathy is a syndrome characterized by the following symptoms:⁵

• Eye abnormalities ophthalmoplegia and nystagmus, which affect eye movement, vision, balance, and coordination
• Mental confusion
• Problems controlling voluntary movements (ataxia)

These symptoms are a result of brain damage from alcohol abuse, in particular, the lower parts of the brain called the thalamus and hypothalamus.¹ A person with wet brain from alcohol may not display all three symptoms.⁵

Wernicke’s encephalopathy is a life-threatening condition as confusion and loss of mental activity can lead to coma and death.¹

Korsakoff’s Psychosis

This condition is also referred to as Korsakoff dementia or Korsakoff psychosis and is characterized by the following symptoms:^1,3,5

• Retrograde and anterograde amnesia, which means that the patient not only cannot remember the past but cannot form new memories either
• Affective disturbance
• Hallucinations—seeing or hearing things that do not exist
• Confabulations—making up stories

Korsakoff’s syndrome is a life-threatening condition as well as it can cause permanent damage, which may lead to stupor and coma.⁵

Is Wernicke Korsakoff Syndrome Reversible?

Wernicke-Korsakoff syndrome is a potentially reversible condition.^4,5 The factors that influence how successfully a case can be alleviated or reversed include the severity of the symptoms, how early treatment is started, and the quality of treatment received.⁴

However, improvements in memory function tend to be slow and often incomplete, and not all people achieve full recovery.⁴ If the patient delays treatment, they may be left with a variety of long-term effects and decrease their chances of alleviating or reversing the symptoms of Wernicke-Korsakoff’s syndrome.⁴

How Is Wet Brain Caused by Alcohol Abuse?

One of the effects of alcohol is that it reduces the absorption of vitamin B1 in the body, destroys the stores of this vitamin in the liver, and interferes with the activity of the enzyme that converts vitamin B1 into an active state. Although vitamin B1 is required by all organs, its deficiency is more detrimental to the nervous and cardiovascular systems than other systems.²

Even up to 80% of individuals with alcohol addiction experience B1 deficiency but only some of them will show signs of the wet brain.³ Statistics show that it occurs in 1-2% of the US population.²

How Is Wet Brain Treated?

While treatment cannot diminish alcohol brain damage that already exists, it can keep the condition under control and prevent its progress.³

Treatment with vitamin B1 can improve brain functions, especially if the person undergoes treatment in the early stages of the condition.³ As a result of this therapy, wet brain recovery is possible in terms of normalizing eye movement and muscle coordination, as well as eliminating confusion and delirium. However, this therapy cannot recover memory loss that occurs in the late stage of alcoholism wet brain disorder.¹

Wet brain treatment can be effective only if the person stops their alcohol abuse and turns to a healthy lifestyle with a balanced diet.¹

How to Get Help for Alcohol Addiction

The first step in getting treatment is acknowledging that there is an issue with alcohol abuse. People are often unaware of the potentially severe and irreversible consequences of excessive drinking just because their condition is still not debilitating and they are still functional in spite of their alcohol addiction.⁶ It is often people from their environment who notice the issue and try to intervene with professional help, which sometimes may give a result.

However, this is very often insufficient and professional help is necessary in addressing addictions, especially if there are complications such as the wet brain syndrome. In such cases, the patient needs to undergo extensive examination and treatment.

What to Expect

There are cases when the person may experience severe alcohol withdrawal symptoms when they try to stop drinking. Detox programs at certified treatment facilities provide the necessary support and ensure that the patient can go through this process safely. After detox, treatment professionals work with patients on relapse prevention in order to maintain abstinence and continue leading a healthy lifestyle after they finish treatment. Treatment can take place in different settings, i.e. levels of care, depending on the severity of the condition and the treatment needs of the particular patient.⁷

While for some patients who need a high level of care intensive outpatient addiction treatment may be sufficient, others may need 24/7 inpatient care. There are also less intensive outpatient alcohol treatment options in situations when patients are stable and are able to visit the treatment facility for their regular treatment appointments.⁷

Who to Call

American Addiction Centers provides several drug and alcohol use disorder treatment options, including treatment in luxury facilities in a number of locations across the country. If you are looking for a way to help a loved one struggling with alcohol abuse, you can visit the website or call our helpline for information and advice on treatment programs, explanation of admission procedures. You can learn more about different types of insurance coverage and available payment options and information by contacting a toll-free alcohol helpline that is always available to treatment seekers.By calling this line, you can talk directly to admission navigators who are able to answer your questions and address all your concerns related to treatment. They can also verify your insurance coverage while you’re still on the phone.