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Wet Brain Syndrome

Wet brain syndrome, also known as Wernicke-Korsakoff syndrome, is a serious disorder and form of dementia associated with heavy alcohol use or alcohol addiction. Left untreated, it can cause permanent brain damage and be life-threatening. Wet brain syndrome occurs in two separate stages: Wernicke encephalopathy and Korsakoff syndrome. While the damage caused by wet brain syndrome can be permanent, prompt treatment can greatly reduce the level of harm a person experiences.[1]

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What Is Wet Brain Syndrome?

Wernicke-Korsakoff syndrome, often referred to as wet brain syndrome, is a pair of conditions, Wernicke encephalopathy and Korsakoff syndrome, that often occur together. [1]

Wet brain syndrome is more common in those who have alcohol use disorder (AUD), although that is not the only thing that can contribute to a person’s risk of developing it. It is a very serious condition that can cause long-lasting, potentially permanent brain damage that can sometimes be fatal.

What Causes Wet Brain Syndrome?

Wet brain syndrome is a brain condition caused by a severe vitamin B1 (thiamine) deficiency. It can be caused by the following issues:[2,11]

  • Chronic heavy drinking associated with alcoholism
  • Cancer
  • Weight loss surgery
  • Anorexia nervosa
  • Hyperthyroidism
  • Liver disease

Researchers say most cases of Wernicke-Korsakoff syndrome occur in people with alcohol use disorder. However, genes could play a role. A mutation in the gene that transports thiamine could allow some people to experience vitamin deficiencies sooner than others.[22]

Wernicke-Korsakoff syndrome is also associated with malnutrition.[22] Anyone who purposefully limits or restricts how much they eat could be at risk for this condition.

Signs & Symptoms of Wet Brain

Wernicke-Korsakoff syndrome typically occurs in two phases: Wernicke’s encephalopathy and Korsakoff syndrome. Each phase has its own set of signs and symptoms.

Wernicke’s Encephalopathy Symptoms

Wernicke’s encephalopathy is an acute and life-threatening phase of wet brain syndrome that is characterized by peripheral neuropathy. This means that the nerves outside of the spinal cord and brain are damaged. Without proper treatment, about 20% of people with Wernicke’s encephalopathy die.[3]

Signs and symptoms of Wernicke’s encephalopathy include the following:

  • Confusion
  • Lack of energy (which could be confirmed with blood pressure or body temperature checks)
  • Lack of coordination, which can look like shaking on one side of the body or poor balance
  • Abnormal eye movements (such as shifting the eyes side to side), crossed eyes, or eyelid drooping

People with this condition may also experience alcohol withdrawal symptoms, such as:[10]

  • Anxiety
  • Agitation
  • Tremors or shakiness
  • Sweating
  • Rapid pulse
  • Insomnia
  • Nausea and vomiting
  • Fever
  • Seizures
  • Hallucinations

Wernicke’s encephalopathy is a medical emergency and requires immediate medical attention. Call 911 or go to the hospital if you suspect you or someone else has developed this dangerous condition.

Without proper treatment, about 20% of people with Wernicke’s encephalopathy die, which is why it’s so important to get medical care immediately.


How Long Does Wernicke’s Encephalopathy Last?

How long it lasts depends on whether a person receives timely treatment or not. If a patient receives prompt and appropriate treatment, vision problems may resolve within 24 hours. [17]

Meanwhile, confusion and motor issues may last for days or months. Learning and memory dysfunction may not completely resolve.[17]

Korsakoff Syndrome Symptoms

If a person survives Wernicke’s encephalopathy, those symptoms tend to fade and progress to Korsakoff syndrome, also called Korsakoff’s psychosis. However, some individuals with Korsakoff syndrome develop this condition without previously having Wernicke’s encephalopathy.[2]

Korsakoff syndrome or Korsakoff’s psychosis, which is caused by chronic B1 deficiency, is characterized by long-lasting and potentially permanent brain damage to areas of the brain associated with memory. This is the phase people think of when they discuss dementia caused by alcoholism.[5]

Signs and symptoms of Korsakoff syndrome include the following:[19]

  •       Severe, irreversible memory impairment
  •       Making up stories about events or remembering them incorrectly
  •       Hallucinations
  •       Repeated speech or actions
  •       Problems with decision-making, planning, organizing, and completing tasks
  •       Lack of motivation

If you suspect someone you care about has Korsakoff’s psychosis, call 911 or take them to the hospital immediately. They require timely medical care and attention.

Prevalence of Wet Brain Syndrome

Up to 80% of people with severe alcohol addiction experience a B1 deficiency. Moreover, Wernicke-Korsakoff syndrome is about 8 to 10 times more common in those with alcohol addiction than in the general population. This is because alcohol decreases gastrointestinal absorption of B1 and thiamine liver stores. Additionally, people with alcohol use disorder tend to consume insufficient vitamins and nutrients like thiamine.[3]

How Is Wernicke-Korsakoff Syndrome Diagnosed?

Wernicke’s encephalopathy can be difficult to diagnose since some of the signs may overlap with intoxication or protracted withdrawal. Plus, people experiencing Wernicke’s encephalopathy may also be going through alcohol withdrawal. However, a clinical diagnosis of Wernicke’s encephalopathy can be made if the person has at least two of these symptoms:[11]

  • Eye or vision signs
  • Cerebellar dysfunction (motor or coordination issues)
  • Altered mental status
  • Deficiency of thiamine

A doctor can make this diagnosis by conducting a thorough physical examination, completing bloodwork, and doing imaging like MRI and CT scan.[11]

Treatment Options for Wet Brain

The goals of Wernicke-Korsakoff syndrome are to control symptoms and keep the condition from worsening.[1] Treatment often involves the following four components:

Vitamin Replacement

For people with acute, early symptoms (Wernicke’s encephalopathy), doctors focus on replacing vitamin B1 before doing anything else.[7] They typically use needles to inject the substance into the bloodstream, as vitamin B1 isn’t easy to digest in an oral dose.

Since people with Wernicke’s can have dangerously low levels of vitamin B1, doctors give very large doses of the substance. In some cases, they give as much as 1500 mg to their patients.[18]


Many people with Wernicke-Korsakoff syndrome are dehydrated when they enter treatment facilities. Doctors offer hydration intravenously to ensure that people get the fluids they need.[19]


Some people improve with vitamin B1 injections alone.[1] Others need glucose injections during their care. And still others need treatment for underlying symptoms, such as diarrhea or headaches.[19]

Treatment in a hospital setting is usually best, as it allows doctors to monitor your progress and adjust your medications as needed.


Korsakoff psychosis may require long-term treatments, including intravenous vitamin B1 replacement and oral supplements.[19] Doctors may also encourage you to eat a healthy diet. The National Library of Medicine says a substance use recovery diet should consist of the following elements:[20]

  • Low-fat foods
  • High levels of protein and complex carbohydrates
  • Plenty of fiber

Drinking water and other clear fluids may be important for your recovery, too. Adult women need nine cups of water per day, and men need 13 cups.[20] Your doctor may recommend even higher doses as you recover. Keep a glass of water nearby at all times, and remind yourself to sip often.

Is the Damage Caused by Wernicke-Korsakoff Reversible?

While Wernicke’s encephalopathy is an acute and reversible condition, the damage caused by Korsakoff’s psychosis or Korsakoff syndrome is not.

Korsakoff syndrome is associated with permanent brain damage. If someone’s condition has progressed to Korsakoff syndrome, IV thiamine treatment may not lead to recovery in about 25% of patients.[3]

With that said, a person can still experience some recovery to their memory with proper treatment for wet brain. This recovery will likely be slow, and it is unlikely that they will ever completely recover to the place they were before they developed brain damage. Still, prompt treatment is the best path forward, including treatment of alcohol use disorder.

Treatment for Alcohol Addiction

People with Wernicke-Korsakoff syndrome should abstain from drinking alcohol. However, this may be difficult for people struggling with alcohol use disorder, the clinical term for alcoholism.

If this is the case, timely and high-quality addiction treatment may be necessary. At Boca Recovery Center, we offer medical detox for safe alcohol withdrawal and comprehensive inpatient rehab services that can help you quit drinking.

Frequently Asked Questions About Wernicke-Korsakoff Syndrome

What is the life expectancy of someone with wet brain syndrome?

The life expectancy of a person with Wernicke-Korsakoff syndrome is highly variable and depends on a person’s overall health and medical comorbidities, such as liver disease. However, one study revealed that more than half of people diagnosed with WKS die within 8 years.[12]

Can a person recover from Korsakoff syndrome?

Yes. About one-quarter of people eventually recover from this syndrome, about half experience partial recovery, and the other quarter don’t experience any improvement.

Is Wernicke-Korsakoff syndrome preventable?

Yes, it is preventable and one of the best ways to do that in a developed country is to moderate your drinking. However, if you have alcohol use disorder, you may be unable to control your alcohol consumption. When Wernicke’s encephalopathy develops, Korsakoff syndrome can be prevented by receiving immediate emergency medical care and thiamine administration.

Is Wernicke-Korsakoff syndrome reversible?

Yes, Wernicke-Korsakoff syndrome is potentially reversible, although this depends on the severity of the condition, how promptly someone gets treatment, and the type of care they receive.[13] People may experience improvement in their symptoms within 5-12 days after receiving B1 therapy.[14] However, about 25% of people with WKS require long-term institutionalization because of the severity of their symptoms.[15]

How much alcohol does it take to get Korsakoff syndrome?

There is no specific amount of alcohol that causes Korsakoff syndrome; however, the longer and heavier a person drinks, the higher their risk is.

What is the average age of people who get Wernicke-Korsakoff syndrome?

WKS most commonly affects men between the ages of 30 and 70 years old, although most cases are those who are 40 and older.[16]

Profile image for Dr. Alison Tarlow
Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated March 22, 2024
  1. Wernicke-Korsakoff Syndrome. (January 2022). National Library of Medicine.
  2. Thiamine Deficiency Unrelated to Alcohol Consumption in High-Income Countries: A Literature Review. (February 2021). Annals of the New York Academy of Sciences.
  3. Thiamin. National Institutes of Health Office of Dietary Supplements.
  4. Vision Loss as a Presenting Feature of Wernicke Encephalopathy. (September 2019). Journal of Neuro-Ophthalmology.
  5. The Evolution and Treatment of Korsakoff’s Syndrome. (May 2012). Neuropsychology Review.
  6. High-Dose Thiamine Strategy in Wernicke–Korsakoff Syndrome and Related Thiamine Deficiency Conditions Associated With Alcohol Use Disorder. (March–April 2021). Indian Journal of Psychiatry.
  7. Wernicke-Korsakoff Syndrome. National Institute of Neurological Disorders and Stroke.
  8. The Korsakoff Syndrome: Clinical Aspects, Psychology and Treatment. (March–April 2009). Alcohol and Alcoholism.
  9. Comprehensive Review of Wernicke Encephalopathy: Pathophysiology, Clinical Symptoms and Imaging Findings. (May 2020). Japanese Journal of Radiology.
  10. Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association. (2013).
  11. Wernicke Encephalopathy Sarayu Vasan; Anil Kumar. National Library of Medicine.
  12. Long-Term Mortality of Patients with an Alcohol-Related Wernicke-Korsakoff Syndrome. Alcohol and alcoholism (Oxford, Oxfordshire), 52(4), 466–471.
  13. The Korsakoff Syndrome: Clinical Aspects, Psychology and Treatment Alcohol and Alcoholism, Volume 44, Issue 2, March-April 2009, Pages 148–154.
  14. Vitamin B1 (Thiamine) Deficiency Kimberly D. Wiley; Mohit Gupta. National Library of Medicine.
  15. Wernicke-Korsakoff Syndrome. Shweta Akhouri; James Kuhn; Edward J. Newton. National Library of Medicine.
  16. Wernicke-Korsakoff Syndrome. Cleveland Clinic.
  17. Wernicke Encephalopathy. Gerald F. O’Malley and Rika O’Malley. Merck Manuals.
  18. Wernicke-Korsakoff Syndrome Treatment and Management. Xiong G. Medscape. Published September 27, 2023. Accessed February 9, 2024.
  19. Wernicke-Korsakoff Syndrome. National Institute on Alcohol Abuse and Alcoholism. Published July 2022. Accessed February 9, 2024.
  20. Substance Use Recovery and Diet. U.S. National Library of Medicine. Published April 30, 2022. Accessed February 9, 2024.
  21. Water. Harvard School of Public Health. Accessed February 9, 2024.
  22. Wernicke-Korsakoff Syndrome. National Organization for Rare Disorders. Published June 8, 2021. Accessed February 9, 2024.
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