While you may have never heard of the medical diagnosis Wernicke-Korsakoff Syndrome (WK syndrome), perhaps you’ve heard the expression “Wet Brain”.
While not a medical term, Wet Brain refers to WK syndrome, a serious neurological disorder caused by a lack of thiamine (vitamin B1) and malnutrition. Most frequently (but not only) experienced by those with Alcohol Use Disorder (AUD), it occurs in up to 2% of people worldwide and causes serious brain damage. Immediate treatment is required.
WK syndrome affects more men than women, usually over age 40, and who primarily have AUD. Women and people who are younger are more likely to develop the syndrome due to other causes, aside from alcohol.
What Is Wet Brain?
Wernicke-Korsakoff Syndrome is a combination of two different brain diseases. It requires immediate treatment and consists of two phases [1]:
- Wernicke encephalopathy, a sudden and severe brain disorder (acute stage).
- Korsakoff psychosis, a long-term memory disorder (chronic stage).
If untreated, Wernicke encephalopathy develops into Korsakoff psychosis. Without rapid treatment, WK syndrome can be disabling, produce permanent memory loss, and be life-threatening.
WK syndrome causes damage to a variety of brain regions, including the thalamus, hippocampus, hypothalamus, and cerebellum. These areas contribute to a wide range of functions such as vision, movement, language, sleep, memory, and motivation [2].
Timeline and Symptoms of Wet Brain
Wernicke encephalopathy develops first. Typically, people with Wernicke encephalopathy present with these main symptoms [2] [3]:
- Confusion
- Lack of energy, hypothermia, low blood pressure, or coma
- Lack of muscle coordination that can affect posture and balance, and can lead to tremors
- Vision problems such as abnormal eye movements (e.g., back and forth movements), double vision, misaligned or crossed eyes, and eyelid drooping
Once these symptoms become long-term, they cause lasting brain and nerve cell damage. This causes severe memory loss and the inability to form new memories, leading to Korsakoff psychosis.
Early warning signs—confusion, balance problems, and changes in eye movements—are sometimes mistaken for intoxication or withdrawal. Symptoms can be similar to both acute alcohol intoxication and alcohol withdrawal. Therefore, it can be difficult to tell WK syndrome symptoms apart from those of heavy drinking, making early identification and diagnosis of WK syndrome difficult for family members or friends.
Korsakoff psychosis tends to develop as Wernicke encephalopathy symptoms go away. Its main symptoms include [4]:
- Inability to form new memories
- Loss of memory, (inability to form new memories) can be severe
- Making up stories to compensate the loss of memory (confabulation)
- Disorientation
- Seeing or hearing things that are not really there (hallucinations)
- Agitation
- Anger
Causes of Wet Brain
Chronic heavy alcohol use irritates the stomach and digestive tract and interferes with the body’s ability to absorb vitamin B1, among others. Poor nutrition in people with severe AUD decreases the gut’s ability to absorb thiamine from food and, therefore, increases the chance of developing WK syndrome. This completely cripples the brain’s ability to use sugar to produce energy, which is critical.
As a result, lack of vitamin B1 is common in people with AUD. It is also common in people whose bodies do not absorb food properly. This can sometimes occur with a chronic illness such as HIV/AIDS or after weight-loss (bariatric) surgery, among other conditions.
Can You Recover From Wet Brain?
Wet Brain is a medical emergency. It requires fast intervention before significant brain damage occurs.
Without treatment, WK syndrome gets steadily worse, and can be life-threatening. It is possible, with treatment, to control some symptoms such as uncoordinated movement and vision difficulties). This disorder can also be slowed or stopped. Without prompt treatment, Wernicke’s disease can progress to Korsakoff’s psychosis, which is not reversible [2].
The goals of treatment are to control symptoms and to prevent the disorder from getting worse. Some people may need to stay in the hospital early in the condition to help control symptoms.
Vitamin B1 is typically given by injection as soon as possible to manage symptoms of Wernicke encephalopathy. Thiamine replacement must be started before nutritional replenishment. This may improve [4]:
- Confusion or delirium
- Difficulties with vision and eye movement
- Lack of muscle coordination
However, Vitamin B1 often does not improve loss of memory and intellect that occur with Korsakoff psychosis.
More loss of brain function and damage to nerves can be limited by stopping alcohol use. As well, a well-balanced, nourishing diet can help, assuming the person has stopped drinking alcohol.
Alcohol Use Disorder Treatment at Northbound Treatment Services
With a focus to support individuals to have successful long-term recovery, at Northbound, we offer a complete treatment program for alcohol use disorder.
Our medically supervised withdrawal management (detox) program supports individuals with the initial stages of stopping alcohol use. We offer residential, partial hospitalization (PHP), intensive outpatient (IOP), and outpatient programs, as well as aftercare.
These programs incorporate a range of therapy approaches, including:
- Acceptance and Commitment Therapy (ACT)
- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavioral Therapy (DBT)
- Motivational Interviewing (MI)
- Solution Focused Therapy (SFT)
- Trauma-Informed Therapy
- Holistic Therapies
- Individual, group, and family therapy as appropriate
When it’s Time to Seek Help, Point Your Compass Northbound
For more than 30 years, Northbound Treatment Services in California has been at the forefront of providing lifesaving, compassionate residential care and specialized services to help people from all walks of life feel better, discover themselves, and live free from addiction.
We have facilities located throughout California to help guide you on your recovery journey. Reach out to our admissions team now.
Sources
[1] Cleveland Clinic. 2022. Wernicke-Korsakoff Syndrome.
[2] National Institute on Alcohol and Alcoholism. 2022. Wernicke-Korsakoff Syndrome.
[3] Kelley L. 2023. The Under-Discussed Consequence of Alcohol Use Disorder: ‘Wet Brain’. University of Colorado Anschutz.
[4] Campellone J. 2024. Wernicke-Korsakoff syndrome. MedlinePlus.
Author
-
I am a Licensed Clinical Social Worker and graduated with a degree from the USC School of Social Work in 2015 with an emphasis in mental health. I began my career working with the Orange County Welfare to Work Program providing mental health services to reduce barriers to employment. I have spent the last 5 years working various levels in behavioral health, providing direct service to those struggling with co-occurring disorders. Using an eclectic and integrative approach, I incorporate the AIP model with EMDR, Person-in-Environment (PIE), Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), family systems, interpersonal and solution-focused therapy along with Rogerian positive regard into my practice.
