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What Is “Wet Brain”? Signs & Symptoms of Wernicke-Korsakoff Syndrome

“Wet brain” (clinically referred to as Wernicke-Korsakoff syndrome or WKS) is a degenerative condition that can develop due to thiamine (vitamin B1) deficiency.1 It can be a potential complication of long-term, heavy drinking and cause a variety of symptoms that affect your brain and body.1

If you misuse alcohol or have a loved one that you’re concerned about, or if you’re experiencing what you think are symptoms of “wet brain,” you may wish to learn more about the condition. This article provides information on WKS, the signs and symptoms of wet brain, and how it’s treated, as well as explains how you can seek help for alcohol misuse or addiction.

What Is Wet Brain?

Wet brain/WKS is a condition that involves a combination of two different but closely related disorders: Wernicke’s encephalopathy and Korsakoff’s psychosis.1

Some scientists consider WKS to be one disorder that is comprised of different stages, with Wernicke’s encephalopathy being the acute stage that can progress to Korsakoff’s psychosis, the more chronic form of the disorder.1

WKS occurs due to thiamine deficiency.1 Although wet brain from alcohol is the most common cause, the disorder can also occur due to anorexia, prolonged vomiting, malnutrition, inflammatory bowel disease, bowel obstruction, systemic disorders like tuberculosis or uremia, or as a side effect of chemotherapy.1, 2

Up to 80% of people with an alcohol use disorder (AUD), the clinical term for alcohol addiction, develop thiamine deficiency, and some of these people go on to develop WKS.3

Around 80 to 90% of people with Wernicke’s encephalopathy progress to the more chronic Korsakoff’s psychosis.4 An estimated 25% of people with WKS require long-term institutional care, depending on their overall level of health and the presence of other co-occurring disorders.2

Wernicke’s Encephalopathy

Wernicke’s encephalopathy is the acute stage of WKS.1 It is a degenerative brain disorder that can occur due to thiamine deficiency.2 Wernicke’s encephalopathy is a medical emergency that can cause coma and death.1, 5

Wernicke’s encephalopathy is characterized by 3 main clinical symptoms, including changes in mental status (e.g., confusion), lack of coordination, and eye abnormalities (e.g., double vision, involuntary eye movements).4

Korsakoff’s Psychosis

Korsakoff’s psychosis is a chronic, debilitating condition that can cause long-lasting learning and memory problems and interferes with normal daily functioning.3 It occurs due to nerve cell damage, damage to cells in the brain and spinal cord, and damage to the part of the brain responsible for memory.1 Korsakoff’s psychosis develops when Wernicke’s encephalopathy goes untreated and symptoms of Korsakoff’s often start as the mental symptoms of Wernicke’s encephalopathy subside.4

A key feature of Korsakoff’s psychosis is anterograde amnesia, which includes trouble learning and storing new information and establishing new memories, although retrograde amnesia, which is trouble retrieving previous memories, may also occur.1

Signs & Symptoms of Wet Brain

Wet brain/WKS can cause a variety of symptoms that can depend on the stage of the disorder that a person is currently in. Wernicke’s encephalopathy and Korsakoff’s psychosis can cause different symptoms. People may not necessarily display all of the symptoms of WKS.4

Signs and symptoms of Wernicke’s encephalopathy can include:1, 4, 5

  • Severe changes in mental status (e.g., confusion).
  • Lack of coordination.
  • Eye abnormalities (e.g., particularly involuntary eye movement in a rhythmic up and down or side by side or circular motion).
  • Gait abnormalities, such as standing or walking with feet spaced widely apart.
  • Low body temperature.
  • Low blood pressure.
  • Lethargy.
  • Inattentiveness.
  • Delirium.
  • Stupor or loss of consciousness.

Signs and symptoms of Korsakoff’s psychosis can include:1, 4

  • Amnesia and memory impairment, especially with short-term memory (e.g., anterograde amnesia).
  • Disorientation.
  • Confabulations (e.g., the creation of false memories that a person truly believes).
  • Tremor.
  • Vision problems.
  • Coma.

Family members or friends might observe certain signs of wet brain in a loved one, such as forgetfulness, especially with short-term memory.3, 4 Someone with WKS may tell stories that you know are “lies” but they truly believe are real. They may get frustrated quickly, walk with legs spread more widely apart or have other difficulties walking, or lacks the usual enthusiasm they have about life.2

Wernicke-Korsakoff syndrome can be persistent and permanent when left untreated.4 Potential outcomes of WKS can include polyneuropathy, meaning damage to multiple peripheral nerves.4 Cardiovascular abnormalities, such as rapid heartbeat can occur as well as low blood pressure upon standing, and syncope, or loss of consciousness.4 Advanced or severe Wernicke-Korsakoff syndrome can lead to coma and death in around 10 to 20% of cases.4

Do I Have Wet Brain?

Wet brain/WKS is a clinical diagnosis that requires an evaluation by a physician. A physician will use their best judgment to determine the cause of your symptoms, but there are no specific laboratory or imaging tests to confirm the diagnosis.6 It can be challenging to diagnose Wernicke-Korsakoff syndrome because symptoms can overlap with those of other alcohol-related conditions, such as intoxication or head injury.6

Your doctor may perform a medical workup and ask about your nutrition, alcohol use, memory, and cognition.6 You may undergo blood tests or other routine lab tests to rule out other conditions.4 Your doctor may also order computed tomography (CT) scans or magnetic resonance imaging (MRI) to rule out tumors, infarcts, and bleeding; CT scans and MRIs may also show brain changes that are associated with WKS.4

Is Wet Brain Reversible?

Many symptoms of Wernicke’s encephalopathy can be reversed if detected and treated promptly.1 It is important to receive timely medical care and to abstain from alcohol to prevent further nerve and brain damage.1 People can recover from memory problems, but it is often a slow and gradual process, and some people can experience only partial recovery.1

Even with treatment, however, some people may not recover, and they may require long-term rehabilitation and support.4 It’s important to be aware that people can suffer serious disability or even die from WKS if they do not receive treatment.1

People with Wernicke’s encephalopathy often receive immediate thiamine supplementation to prevent the progression of the disorder.4, 7 People who receive treatment can experience improvement in mental status and eye symptoms within days or weeks, and with coordination problems within a few weeks (but it can take several months to fully recover).4, 7 Coordination problems and involuntary eye movements may persist for some people.7

If the condition progresses to Korsakoff’s psychosis, people can suffer from permanent brain damage and memory impairment.7

How Is Wet Brain Treated?

Wet brain/WKS is treated with different methods that mainly involve thiamine supplementation, electrolyte and vitamin supplementation, dietary therapy, hydration, and in some cases, drug therapy, as well as medical monitoring of symptoms.1, 6 Discontinuing and abstaining from alcohol and maintaining a healthy diet is an important aspect of treatment and can help prevent further brain damage.1

Depending on your symptoms, you may require additional treatment from medical professionals such as neurologists, psychiatrists, ophthalmologists, cardiologists, physical therapies, or gastroenterologists.4 Some people may also benefit from psychotherapies such as cognitive-behavioral therapy to help with an alcohol use disorder or other associated mental disorders.4

Getting Help for Alcohol Misuse or Addiction

If you or someone you love is struggling with alcohol misuse or addiction, you should know that AUD is treatable. American Addiction Centers (AAC) is a leading provider of evidence-based alcohol addiction treatment and has facilities across the U.S. You can call our free, confidential helpline at to talk to an admissions navigator who can discuss treatment options, answer any questions you may have, and verify your insurance.

FAQs About Wet Brain from Alcohol

 

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