Korsakoff's Syndrome

Treatment of both Korsakoff's and Wernicke's syndromes involves the immediate administration of thiamine. In fact, any individual who is hospitalized for any reason and who is suspected of being an alcoholic, must receive thiamine. The combined Wernicke-Korsakoff syndrome has actually been precipitated in alcoholic patients hospitalized for other medical illnesses, by the administration of thiamine-free intravenous fluids (intravenous fluids are those fluids containing vital sugars and salts which are given to the patient through a needle inserted in a vein).

Fifteen to 20% of all patients hospitalized for Wernicke's syndrome will die. Although the degree of ataxia nearly always improves with treatment, half of those who survive will continue to have some permanent difficulty walking. The paralysis of the eye muscles almost always resolves completely with thiamine treatment. Recovery from Wernicke's begins to occur rapidly after thiamine is given. Improvement in the symptoms of Korsakoff's syndrome, however, can take months and months of thiamine replacement. Furthermore, patients who develop Korsakoff's syndrome are almost universally memory-impaired for the rest of their lives. Even with thiamine treatment, the memory deficits tend to be irreversible, with less than 20% of patients even approaching recovery. The development of Korsakoff's syndrome often results in an individual requiring a supervised living situation.