Korsakoff syndrome, more formally called Wernicke-Korsakoff syndrome, is one of the less-talked-about complications of chronic alcohol abuse. This is a form of alcohol-induced amnesia, along with other neurological symptoms, that occurs in around 2% of the human population. The condition isn’t evenly distributed around the world, with relatively low incidence in France and much higher rates in Australia. In the United States, up to 2% of adults have some symptoms of Korsakoff syndrome, heavily concentrated among the homeless, residents of mental health institutions and seniors living alone. Learn more about the causes and symptoms of this serious neurological disorder.

What Is Korsakoff Syndrome?

Korsakoff syndrome is a form of progressive dementia caused by the ongoing thiamine (vitamin B1) deficiency many heavy drinkers experience. In healthy bodies, thiamine is absorbed from food in the small intestine. Alcohol irritates and causes damage to the intestinal lining, which impairs its ability to pass essential vitamins to the bloodstream. Heavy drinking over a period of many years tends to permanently reduce the body’s ability to absorb vitamin B1, regardless of how much a person gets with food.

Having low levels of thiamine causes brain damage. This damage is concentrated in the limbic system, which is heavily involved in how the brain lays down new memories and moves short-term memories to long-term storage. This part of the brain is also involved with voluntary body movements and regulating emotions. Damage to this region affects all these processes, leading to confusion, loss of motor control, memory impairment and the permanent loss of brain tissue.

How Much Alcohol Do You Have to Drink to Get Korsakoff Syndrome?

Symptoms of Korsakoff syndrome can develop fast. After just 7-10 days without thiamine, brain cells tend to shed sugar and lose their ability to function. Within 2 weeks, the affected cells may be permanently lost, which is when the syndrome moves into its chronic, or permanent, phase. As brain cells are lost, the blood-brain barrier breaks down, allowing toxic substances to pass more freely into the delicate tissues of the brain, accelerating the damage.

There isn’t a fixed amount of alcohol you have to drink to develop Korsakoff syndrome. Every person is different, and the chain of events that leads to the syndrome developing is complicated, involving not just alcohol intake but the permeability of the intestines, the resilience of brain tissue and the presence of other harmful chemicals in the person’s blood. Some people develop a serious thiamine deficiency after relatively moderate alcohol use over a period of time, while other people drink heavily for many years and still show few or none of the symptoms.

What Is the Main Symptom of Korsakoff Syndrome?

The main symptom of Korsakoff syndrome is memory impairment, which comes in two forms: retrograde and anterograde amnesia. Retrograde amnesia involves losing past memories, while anterograde amnesia is the inability to lay down new memories in the present. Both of these types of memory depend on the limbic system to properly function, and the damage caused by Korsakoff syndrome hits that area the hardest.

Interestingly, people with early-stage Korsakoff syndrome may not be able to recognize the symptoms themselves at first. In fact, many people around the person might miss the signs early on as well. Part of the reason for this lies in how the brain tries to compensate for losing function. If you try to recall an event from the past, or if you were just told something and you have to remember it a few minutes later, your brain might react to the loss of its memories by confabulating new ones. Confabulation is when the brain doesn’t have information available, so it effectively guesses at what the missing data would be and recalls it as if it was accurate. Thus, a person with advancing brain damage might answer a simple question about what they had for breakfast with a false statement but be unaware that it’s false or that they don’t actually remember breakfast at all.

What Is the Major Symptom of Korsakoff Psychosis?

As the disease process develops, people with advanced Korsakoff syndrome may wind up with Korsakoff psychosis. The major symptom of this condition is disorientation to time. This frequently shows up as confusion about what day it is or what the date happens to be. It can even include forgetting what year it is or the person’s own age.

This can be upsetting for many people, but a loss of normal emotional affect is another common symptom of Korsakoff psychosis. People with the condition can become mildly euphoric for no apparent reason or even in the presence of dangerous or distressing events. People with this altered mental state are often described as seeming bland or uninterested in the world around them or as being unable to track what’s going on.

What Are Your Treatment Options?

Unfortunately, there’s no cure for Korsakoff syndrome. In its earliest phase, known as Wernicke’s encephalopathy, the progress of the disease can usually be stopped and even reversed, if the condition is identified and properly treated right away. Treatment at this stage involves taking hefty doses of thiamine replacement, followed by rehydration and nutritional support. Some drugs can also help, but the treatment has to be done under the close supervision of a doctor. People going through this treatment can experience significant discomfort because they usually have to stop drinking after years of heavy substance abuse.

If the syndrome is allowed to proceed to the point that brain cells are irretrievably lost, a full recovery may be impossible. Stopping alcohol intake and going through medically supervised therapy generally slows the damage down and even brings some improvements, but some memory function is usually gone forever, and recovering motor control is generally slow and incomplete. Left untreated, the continued degeneration of the brain tissue can become disabling and eventually life-threatening.

Don’t Wait to Get Help

If you’re beginning to pay the price for years of drinking with alcohol-induced amnesia, you don’t have to accept the medically dangerous outcomes of Korsakoff syndrome. The caring addiction specialists at Sunlight Recovery are available 24/7 to help you start your recovery before it’s too late. Contact us now for compassionate advice and help getting the treatment you need for a lifetime of sobriety and better health.