that indicate alcohol withdrawal may also be present or may develop.
Signs and tests:
History is significant for chronic alcohol use. 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 indicate 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. The person may appear cachectic (malnourished).
A nutritional assessment may confirm malnourished state, serum B-1 levels may be low, pyruvate is elevated, and transhetolase activity is decreased. Serum or urine alcohol levels may be elevated (see toxicology screen).
A cranial MRI rarely shows changes in the tissue of the brain indicating Wernicke-Korsakoff syndrome.
The goals of treatment are to control symptoms as much as possible and to prevent progression of the disorder. Hospitalization is required for initial control of symptoms. If the person is lethargic, unconscious, or comatose, monitoring and care appropriate to the condition may be required. The airway should be monitored and protected as appropriate.
Thiamine (vitamin B-1) may improve symptoms of confusion or delirium, difficulties with vision and eye movement, and muscle incoordination. B-1 may be given by injection into a vein or a muscle, or by mouth. Thiamine does not generally improve loss of memory and intellect associated with Korsakoff psychosis.
Total abstinence from alcohol is required to prevent progressive loss of brain function and damage to peripheral nerves. A well-balanced, nourishing diet is recommended.
Without treatment, Wernicke-Korsakoff syndrome progresses steadily to death. With treatment, symptoms such as incoordination and vision difficulties may be controlled, and progression of the disorder may be slowed or stopped. Some of the symptoms, particularly the loss of memory and intellect/cognitive skills, may be permanent. There may be a need for custodial care if the loss of intellect/cognitive skills is severe. Other disorders related to the abuse of alcohol may also be present.
This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
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