Wernicke-Korsakoff syndrome, sometimes called cerebral beriberi, is a severe memory disorder usually associated with chronic excessive alcohol consumption, although the direct cause is a deficiency in thiamin (vitamin B1). It may also result from dietary deficiencies, prolonged vomiting, eating disorders, or the effects of chemotherapy medications.
Wernicke-Korsakoff syndrome was first identified in the late nineteenth century. Although Wernicke's and Korsakoff's may appear to be two different disorders, they are generally considered to be different stages of the same disorder, which is called Wernicke-Korsakoff syndrome.
Wernicke-Korsakoff syndrome includes Wernicke's encephalopathy and Korsakoff's syndrome (or Korsakoff's amnesic syndrome or Korsakoff's psychosis). Wernicke's encephalopathy is the first or acute phase of Wernicke-Korsakoff syndrome, and usually includes symptoms of acute mental confusion, ataxia (lack of coordination), and ophthalmoplegia (weakness or paralysis of the eye).
Korsakoff's syndrome represents the chronic (long-term) phase of the syndrome, which manifests as a memory disorder. Symptoms include amnesia, fabrication (making false statements) of memory, attention deficit, disorientation, and vision impairment. The main features of Korsakoff's syndrome are the impairments in acquiring new information or establishing new memories, and in retrieving previous memories. Korsakoff's syndrome is also known as alcohol-induced persisting amnestic disorder.
The estimated number of individuals with Wernicke-Korsakoff syndrome is between one and two percent of the population in the United States. Wernicke's encephalopathy is fairly rare, and accounts for about 0.05% of all hospital admissions, although this does not account for patients who do not seek medical attention.
Wernicke-Korsakoff syndrome usually follows many years of chronic alcoholism or malnutrition and is seldom seen among people less than 20 years of age. Most patients are 40 years of age or older. The disorder is apparently more common in alcoholic individuals who are particularly vulnerable to malnutrition such as indigent or homeless people.
Primary thiamin deficiency:
Primary thiamin deficiency is caused by inadequate intake of thiamin (vitamin B1). It is commonly due to a diet of highly refined carbohydrates (such as white rice, white flour, and white sugar) and processed foods. It also develops when intake of other nutrients is inadequate, including other B vitamin deficiencies.
Secondary thiamin deficiency: Secondary thiamin deficiency is caused by increased demand of the vitamin, due to conditions such as hyperthyroidism (high levels of thyroid hormone), pregnancy, lactation, strenuous exercise, fever, impaired absorption (as in prolonged diarrhea or irritable bowel syndrome (IBS), or impaired metabolism (such as due to hepatic or liver insufficiency or diabetes).
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