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Central nervous system
Central nervous system


Wernicke-Korsakoff syndrome

Alternative Names:
Korsakoff psychosis; Alcoholic encephalopathy; Encephalopathy - alcoholic; Wernicke's disease

Symptoms:
Note: Symptoms that indicate alcohol withdrawal may also be present or may develop.

Signs and tests:
  • Examination of the nervous/muscular system may show polyneuropathy (damage to multiple nerve systems).
  • Reflexes may be decreased (or of abnormal intensity), or abnormal reflexes may be present.
  • Testing of gait and coordination indicates damage to portions of the brain that control muscle coordination.
  • Muscles may be weak and may show atrophy (loss of tissue mass).
  • Examination of the eyes shows abnormalities of eye movement.
  • Blood pressure and body temperature measurement may be low.
  • Pulse (heart rate) may be rapid.
Text Continues Below



The person may appear cachectic (malnourished). A nutritional assessment may confirm malnourished state.

  • Serum B1 levels may be low.
  • Pyruvate is elevated.
  • Transketolase activity is decreased.

If the history is significant for chronic (long-term) alcohol abuse, serum or urine alcohol levels may be elevated (see toxicology screen) and liver enzymes may be elevated.

Other chronic conditions that may cause a thiamine deficiency include the following:

  • AIDS
  • Hyperemesis gravidarum (continuous nausea and vomiting during pregnancy)
  • Thyrotoxicosis (very high thyroid hormone levels)
  • Cancers that have spread throughout the body
  • Long-term dialysis
  • Congestive heart failure, when treated with long-term diuretic therapy

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