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Untreated Alcoholism and the Risks of Wet Brain Syndrome
Learn more about the condition known as Wernicke-Korsakoff syndrome
Hazelden Betty Ford Foundation
Published Feb 19, 2019
A forgotten birthday. A repeated story. Confusion over a simple task. For heavy drinkers, these seemingly innocent memory lapses can evolve to slurred speech, an unsteady walk, violent muscle twitches or hallucinations, signaling alcohol-induced brain damage. If left untreated, the damage can progress to Wernicke-Korsakoff syndrome, a potentially life-threatening condition.
Is Wernicke-Korsakoff syndrome the same as Wet Brain?
You might hear the dated term "wet brain" used in reference to Wernicke-Korsakoff syndrome. However, the term "wet brain" carries and perpetuates stigma by inaccurately conveying that people willfully contract it. The truth is two people can have similar drinking patterns and one will develop Wernicke-Korsakoff syndrome and the other won't. It’s a complex condition with many factors and, like alcohol use disorder, no one chooses it. As such, we recommend that the term "wet brain" be avoided in favor of the more accurate "Wernicke-Korsakoff syndrome."
How Does Chronic Drinking Affect the Brain?
Every cell in the body needs vitamin B1 (thiamine) in order to function. Every cell. This workhorse vitamin converts food into energy in the brain, nerves and heart. It helps the body process fats and proteins and break down carbohydrates.
Your body can't produce thiamine on its own—it has to be ingested through your diet. This is typically a non-issue for most healthy adults (think whole grains, asparagus, kale, pork, beef, chicken, eggs and potatoes). Those who struggle with alcohol use disorder, though, are at risk of thiamine deficiency. Why? Instead of eating a balanced diet, many alcoholics drink their calories, depriving their bodies of essential vitamins. In other cases, an alcohol-induced inflammation of the stomach lining reduces the body's ability to absorb vitamins.
According to the National Institute on Alcohol Abuse and Alcoholism, "chronic alcohol consumption can cause thiamine deficiency and reduced enzyme activity, including inadequate dietary intake, malabsorption of thiamine from the gastrointestinal tract, and impaired utilization of thiamine in the cells."
Thiamine deficiency isn't just an annoyance. Without thiamine, the brain can't process glucose, robbing the brain of energy (and functioning). This can lead to a serious neurological disorder known as "wet brain syndrome"—better known in the medical community as Wernicke-Korsakoff syndrome.
Understanding Wernicke-Korsakoff Syndrome
So, what—exactly—is a "wet brain?" According to the National Organization for Rare Disorders, Wernicke-Korsakoff syndrome is really two different disorders. Wernicke's is a neurological disease characterized by "confusion, the inability to coordinate voluntary movement and eye (ocular) abnormalities," while Korsakoff's is a mental disorder characterized by disproportionate memory loss. Because the ability to form new memories is almost nonexistent, a person with Wernick-Korsakoff syndrome might be too confused to find their way out of a room or remember what's been said just 20 minutes before, consistently repeating questions or comments during a conversation.
As summarized by healthline.com, "Wernicke's disease affects the nervous system and causes visual impairments, a lack of muscle coordination, and mental decline. If Wernicke's disease is left untreated, it can lead to Korsakoff syndrome. Korsakoff syndrome permanently impairs memory functions in the brain." How does wet brain kill you? Without thiamine, the tissue of the brain begins to deteriorate. Korsakoff's syndrome dementia affects not just the brain, but also the cardiovascular and central nervous system. Once a person has been diagnosed with end stage alcoholism, life expectancy can be as limited as six months.
In many ways, a person struggling with alcohol addiction and showing symptoms of second-phase wet brain acts much like someone with Alzheimer's disease. Based on statistics from the National Institute on Alcohol Abuse and Alcoholism, 90 percent of alcoholics suffering from stage 1 symptoms go on to develop stage 2, with some overlap between the stages and symptoms.
Symptoms: Stage 1
- Drowsiness and paralysis of eye movements
- Rapid, tremor-like eye movements
- Visual and auditory hallucinations
- Ataxia (unsteady gait caused by weakness in limbs or lack of muscle coordination)
- Affected sense of smell
- Delirium Tremens (the shakes)
- Confusion, agitation or inattentiveness
Symptoms: Stage 2
- Alcohol-related memory loss (from mild to severe)
- Disorientation with regard to time and place
- Distorted or misinterpreted memories
- Made up or invented information to compensate for poor memory
- Mental disturbances
- Dementia
- Hallucinations
- Impaired ability to learn new tasks
- Coma (advanced stages)
About 1-2 percent of the population is affected by wet brain, according to research by the National Organization for Rare Disorders. Men suffering from alcohol abuse, between 30-70 years, are slightly more affected than women of the same age. Of those who develop Wernicke-Korsakoff syndrome, about 25 percent require long-term treatment in a hospital setting. There's no single test for the syndrome, but a good indication, particularly when disorientation and confusion are apparent, is testing vitamin B1 levels in the blood. Research conducted by the Alzheimer's Association estimates that when caught early enough, approximately 25 percent of people will recover, 50 percent will improve and 25 percent will stay the same. However, once the syndrome has progressed to the point of no return—no new memories or experiences, no reversing the symptoms—the disease is generally fatal. The grim reality of chronic alcohol abuse is that the body can only handle so much; and Wernicke-Korsakoff syndrome is a tragic, heartbreaking consequence of the abusive nature of alcoholism. A failure to diagnose this syndrome leads to death in 20 percent of cases, and long-term brain damage in 75 percent.
Is Wernicke-Korsakoff Syndrome Treatable?
The good news—if caught early enough—is that wet brain syndrome is a preventable, treatable disease if you stop drinking and seek help. Intense thiamine replacement therapy and abstinence from alcohol can result in a noticeable improvement in both mental and physical functioning within weeks.
If you're concerned about vitamin B1 depletion or know someone experiencing co-occurring wet brain symptoms as a result of drinking alcohol, it's essential that you get professional help. Reach out today, before chronic conditions develop, and a health care or recovery expert will help guide you in next steps.