Wet brain syndrome, also referred to as Wernicke-Korsakoff syndrome, is a brain disorder due to vitamin B1 deficiency. Learn more about Wet Brain (Wernicke-Korsakoff Syndrome), symptoms, links between Alcoholism, diagnosis, complications, & treatment.
By We Level Up NJ Treatment Center | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: February 1, 2023
What Is Wet Brain Syndrome?
Wet brain syndrome, also referred to as Wernicke-Korsakoff syndrome, is a brain disorder due to vitamin B1 deficiency. This happens all too often among individuals who have an alcohol problem as alcohol use disorder causes a lack of vitamin B1. In addition, wet brain happens when two different conditions, Wernicke encephalopathy, and Korsakoff syndrome, occur concurrently. Both of these problems are due to brain damage caused by a lack of vitamin B1.
According to the National Institute of Neurological Disorders and Strike (NINDS) , wet brain may result from alcohol abuse, dietary deficiencies, prolonged vomiting, eating disorders, or the effects of chemotherapy. B1 deficiency causes damage to the brain’s thalamus and hypothalamus. Wet Brain Syndrome symptoms include mental confusion, vision problems, coma, hypothermia, low blood pressure, and lack of muscle coordination (ataxia).
Korsakoff syndrome (also called Korsakoff’s amnesic syndrome) is a memory disorder that results from vitamin B1 deficiency and is associated with alcoholism. Korsakoff’s syndrome damages nerve cells and supporting cells in the brain and spinal cord, as well as the part of the brain involved with memory. Symptoms include amnesia, tremor, coma, disorientation, and vision problems, The disorder’s main features are problems in acquiring new information or establishing new memories and retrieving previous memories.
Although Wernicke’s and Korsakoff’s are related disorders, some scientists believe them to be different stages of the same disorder, which is called Wernicke-Korsakoff syndrome. Wernicke’s encephalopathy represents the “acute” phase of the disorder and Korsakoff’s amnesic syndrome represents the disorder progressing to a “chronic” or long-lasting stage.
Symptoms of Wernicke-Korsakoff syndrome
Symptoms of Wernicke encephalopathy include:
- Confusion and loss of mental activity can progress to coma and death
- Loss of muscle coordination (ataxia) that can cause leg tremors
- Vision changes such as abnormal eye movements (back and forth movements called nystagmus), double vision, eyelid drooping
- Alcohol withdrawal
Normal mental activity can become harder and harder for the individual to maintain as Wernicke’s progresses. It can potentially become so severe, in fact, that it progresses into coma-like states and even death. This is one reason why the early signs of this disorder should not be ignored.
Symptoms of Korsakoff syndrome include:
- Inability to form new memories
- Loss of memory can be severe
- Making up stories (confabulation)
- Seeing or hearing things that are not really there (hallucinations)
Like Wernicke’s encephalopathy, Korsakoff’s syndrome can eventually lead to coma and death. As a joint problem, both of the syndromes that make up wet brain are extremely severe and should be dealt with as soon as possible in order for the individual to be able to avoid further, serious effects.
Causes of Wet Brain Syndrome
Severe Wet Brain Syndrome is caused by the accumulation of fluid in the brain and, in some cases, irreversible damage to brain cells. Individuals affected by this condition are typically unable to live independently and require long-term care or support. In addition, mobility may become impaired, and individuals may require physical or occupational therapy. Treatment options for Severe Wet Brain Syndrome can include medications to reduce symptoms, physical and occupational therapy, speech therapy, and lifestyle modifications.
Severe Wet Brain Symptoms
The symptoms of severe Wet Brain Syndrome can vary depending on the severity of the condition. In general, they may include: confusion and disorientation, speech and language delays, memory deficits, and increased impulsivity, difficulty completing tasks, impaired motor coordination, incontinence, difficulties with coordination and balance, tremors, and seizures.
The most common symptoms of Severe Wet Brain Syndrome include memory loss, impaired cognitive function, difficulty with balance and coordination, confusion, varying levels of mental confusion, impaired motor function, muscle weakness, vision problems, and difficulty speaking. In more severe cases, individuals may experience seizures, coma, or even death.
Other symptoms of Severe Wet Brain Syndrome may include changes in behavior and personality, severe depression, agitation, and anxiety, increased risk of suicide and self-harming behavior, hallucinations, paranoia, and delusions. It can also cause difficulty with reasoning and problem-solving, as well as poor judgment and decision-making. In addition, people with this condition may have difficulty understanding abstract concepts and difficulty with executive functioning skills.
Common Wet Brain Symptoms
The main symptoms associated with wet brain (or Wernicke-Korsakoff Syndrome) include confusion, memory problems, and difficulty forming new memories. Other common symptoms include difficulty concentrating, loss of coordination, lack of appetite, depression, fatigue, and vision changes. In severe cases, disorientation, hallucinations, and paranoia may occur.
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The Link Between Alcohol Abuse And The Wernicke Korsakoff (Wet Brain)
Alcohol abuse is strongly linked to wet brain syndrome, also known as Wernicke-Korsakoff Syndrome (WKS). WKS is caused by a vitamin B1 deficiency, which is often caused by heavy drinking or starvation. Alcohol impairs the digestive system’s ability to properly absorb B1, leading to a deficiency in the vitamin and potentially resulting in the development of wet brain syndrome.
Wet brain syndrome is a severe form of thiamine deficiency, which is caused by a lack of the vitamin B-1 that helps the body to produce energy. It is most often seen in heavy drinkers and those with an unhealthy diet who do not receive enough of the vital vitamin in their diet. Symptoms of wet brain syndrome can include memory loss, delusions, disorientation, and even extreme changes in emotional state as the brain is not able to properly process incoming information.
Wet Brain Syndrome Statistics
According to estimates from the National Institute on Alcohol Abuse & Alcoholism, about 1 in 8 people who misuse alcohol develop some form of thiamine deficiency, which includes wet brain syndrome. Additionally, some estimates suggest that wet brain syndrome affects around 10-15% of people with alcohol dependence.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA)  reported that in 2019, 85.6 percent of people ages 18 and older reported that they drank alcohol at some point in their lifetime. Drinking alcohol in moderate amounts is not necessarily bad, and alcohol is even reported to have certain health benefits. The Dietary Guidelines for Americans define responsible drinking as drinking only once daily for women and twice a day for men, commonly considered the safe zone. Consuming more than these levels may result in binge drinking, and if this goes on for an extensive period of time, it may lead to substance abuse, alcohol addiction, or wet brain.
Extensive abuse of alcohol, or alcoholism, carries many harmful health implications and side effects, such as developing a wet brain. Reports from the NIAAA  show that up to 80 percent of alcoholics may have thiamine (vitamin B1) deficiencies, and some of these people will go on to develop serious brain disorders such as Wernicke–Korsakoff syndrome (wet brain).
Thiamine is a crucial vitamin responsible for helping the body metabolize and use sugars to create energy successfully. In wet brain cases, thiamine levels are compromised through poor eating habits. The links between chronic alcoholism and these conditions are heightened because alcoholics tend to make poor dietary and lifestyle choices, resulting in brain damage. In addition, the withdrawal symptoms of alcohol abuse include nausea and vomiting, which further drain fundamental vitamins and minerals from the body.
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What Is Korsakoff’s Psychosis?
According to NIAAA ]5], approximately 80 to 90 percent of alcoholics with Wernicke’s encephalopathy also develop Korsakoff’s psychosis, a chronic and debilitating syndrome characterized by persistent learning and memory problems. A person with Korsakoff’s psychosis is forgetful and quickly frustrated and has difficulty with walking and coordination. Although these individuals have problems remembering old information (i.e., retrograde amnesia), it is their difficulty in “laying down” new information (i.e., anterograde amnesia) that is the most striking. For example, these individuals can discuss an event in their lives in detail, but an hour later might not remember ever having the conversation.
According to the National Center for Biotechnology Information (NCBI) , The cognitive deficits seen in Korsakoff syndrome are thought to be primarily due to damage to the following areas- the anterior nucleus of the thalamus, mammillary bodies, and corpus callosum. There is also evidence of decreased glucose metabolism in the cerebral cortex. Cerebellar degeneration is also common among alcoholics and can lead to the ataxia and oculomotor deficits seen in Wernicke-Korsakoff syndrome.
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Wet Brain Syndrome Diagnosis (Exams And Tests)
Examination of the nervous/muscular system may show damage to many nerve systems:
- Abnormal eye movement
- Decreased or abnormal reflexes
- Fast pulse (heart rate)
- Low blood pressure
- Low body temperature
- Muscle weakness and atrophy (loss of tissue mass)
- Problems with walking (gait) and coordination
The person may appear poorly nourished. The following tests are used to check a person’s nutrition level:
- Serum albumin (relates to a person’s general nutrition)
- Serum vitamin B1 levels
- Transketolase activity in red blood cells (reduced in people with thiamine deficiency)
Liver enzymes may be high in people with a history of long-term alcohol abuse.
Other conditions that may cause vitamin B1 deficiency include:
- Cancers that have spread throughout the body
- Extreme nausea and vomiting during pregnancy (hyperemesis gravidarum)
- Heart failure (when treated with long-term diuretic therapy)
- Long periods of intravenous (IV) therapy without receiving thiamine supplements
- Long-term dialysis
- Very high thyroid hormone levels (thyrotoxicosis)
A brain MRI may show changes in the tissue of the brain. But if Wernicke-Korsakoff syndrome is suspected, treatment should start immediately. Usually, a brain MRI exam is not needed. A person must be sober when demonstrating symptoms to be diagnosed with wet brain, considering that withdrawal or medical complications associated with alcohol use can mimic symptoms of Wernicke-Korsakoff Syndrome.
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Is Wernicke Korsakoff Syndrome (Wet Brain) Reversible?
According to the NCBI , Wernicke encephalopathy is acute and often reversible, while Korsakoff syndrome is chronic and may be irreversible. However, the severity of a person’s symptoms, how early a person begins treatment, and the type of treatment they receive can all significantly impact whether a case of Wernicke encephalopathy can be reversed or alleviated. Some people may make a full recovery, although this is rare. Thiamine therapy will offer varying levels of improvement in symptoms after 5-12 days. Early intervention is the best way to increase the body’s ability to restore normal function.
Possible Complications Of Wet Brain Syndrome
Wet brain symptoms and complications that may result include:
- Alcohol withdrawal
- Difficulty with personal or social interaction
- Injury caused by falls
- Permanent alcoholic neuropathy
- Permanent loss of thinking skills
- Permanent loss of memory
- Shortened life span
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Wet Brain Treatment
According to NIAAA, the cerebellum, an area of the brain responsible for coordinating movement and perhaps even some forms of learning, appears to be particularly sensitive to the effects of thiamine deficiency and is the region most frequently damaged in association with chronic alcohol consumption. Administering thiamine helps to improve brain function, especially in patients in the early stages of the wet brain.
When damage to the brain is more severe, care shifts from treatment to providing support to the person and their family. Custodial care may be necessary for the 25 percent of patients who have permanent brain damage and significant loss of cognitive skills. The treatment goals are to control symptoms and prevent the disorder from getting worse.
Scientists believe that a genetic variation could be one explanation for why only some alcoholics with thiamine deficiency go on to develop severe conditions such as WKS. Still, additional studies are necessary to clarify how genetic variants might cause some people to be more vulnerable to WKS than others.
Early-stage wet brain treatment can limit and even reverse the harmful effects of thiamine deficiency on people suffering from the condition. There are three main methods for early-stage treatment, which should all be applied together:
- Vitamin B1/Thiamine supplements
- Abstinence from alcohol
- Eating a well-balanced and nutritious diet
Part of treating wet brain as a challenge is that abstinence from alcohol is extremely difficult. Becoming sober and permanently giving up alcohol will prevent further brain function loss and nerve damage.
Addiction treatment, such as an intervention or medically-assisted detox at an inpatient treatment center, might be necessary to accomplish this. Alcohol withdrawal symptoms can be pretty painful. And in some cases, deadly. It is essential to take the appropriate steps to ensure one life-threatening condition is not exchanged for another by quitting cold turkey.
If you have an alcohol use disorder and a mental health problem, it is essential to seek help for both conditions. Once a proper and comfortable detox is in place and thiamine levels are elevated from Vitamin B1 shots, eating a nutritious and balanced diet is all that’s left to do. This ensures the effects of the wet brain are mitigated to the extent that it is possible.
Depending on the severity and stage of the condition, this could lead to a full recovery. However, it might only stop the syndrome from progressing even further. Either way, it will improve the devastating effects caused by untreated Wernicke-Korsakoff syndrome.
Although, there are different alcoholics, alcoholic personalities, and tolerances. The health effects are the same, especially long term. Unlike Alzheimer’s disease, WKS symptoms will not get worse over time if you undergo treatment early on.
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