According to the charity Alcohol Change UK, alcohol misuse is the biggest risk factor for death, ill-health and disability among 15-49 year-olds in the UK – and the fifth biggest risk factor across all ages. 

Alcohol is also a recognised causal factor in more than 60 medical conditions, including high blood pressure, liver cirrhosis, depression and even several types of cancer.

One of the lesser-known risks of alcohol abuse is the condition commonly known as wet brain, or wet brain syndrome. This is a degenerative brain disorder that can lead to permanent brain damage and severe problems with memory.


What is Wet Brain Syndrome?

Wet brain syndrome is better known as Wernicke-Korsakoff syndrome (WKS) and is caused by a lack of thiamine (vitamin B1).  

Wet brain syndrome consists of two associated and overlapping conditions – Wernicke encephalopathy and Korsakoff amnesic syndrome. These can essentially be seen as different stages of the same disease, with Wernicke’s encephalopathy being the acute phase of the condition and Korsakoff’s syndrome representing the chronic or long-lasting stage. 

Korsakoff amnesiac syndrome usually follows Wernicke’s encephalopathy, but according to the Alzheimer’s Association, it can also develop in individuals who have not had a prior episode of Wernicke encephalopathy.

Carl Wernicke first described acute encephalopathy as far back as 1881, characterising it with mental confusion, paralysis of the eye, nystagmus (a repetitive and involuntary movement of the eyes) and the presence of abnormal, uncoordinated movements. 

A few years later, Russian psychiatrist Sergei Korsakoff extended the syndrome by including memory loss and confabulation (a generation of false memory) in the overall condition, now known as WKS, wet brain and wet brain syndrome.

Whether you know it as Wernicke-Korsakoff Syndrome or wet brain syndrome, it’s a really serious health issue that needs to be taken seriously.

It has very similar effects when compared to those living with dementia, and there’s evidence to suggest that a link is present between alcoholism and wet brain syndrome.


Causes of Wet Brain Syndrome

Wet brain syndrome is primarily caused by a deficiency of vitamin B1, also known as thiamine or thiamine. 

The NHS reported that this vitamin helps to turn food into energy and to keep the nervous system healthy

And, while the body does not produce this substance naturally, we usually get all we need from the food we eat. Some foods such as whole grain pasta, flour and wheat, eggs, beef and pork are high in thiamine. 

A thiamine deficiency can result in a number of serious health problems, including Wernicke encephalopathy – the first stage of wet brain or WKS.

It is not fully understood how thiamine deficiency causes Wernicke encephalopathy, but it is known that wet brain most commonly affects people who drink excessive amounts of alcohol. 

According to the Alcohol and Drug Foundation, up to 80% of people with chronic alcoholism develop a thiamine deficiency (although not everyone with a deficiency develops wet brain syndrome).

One reason is that drinking alcohol causes inflammation of the stomach lining and digestive tract, reducing the body’s ability to absorb vitamins. People with chronic alcohol problems are also much more likely to neglect other areas of their life, including eating well and getting the right nutrition.

Some other risk factors include:

  •   Anorexia and other eating disorders.
  •   Fasting, starvation and some weight-loss surgery.
  •   AIDS.
  •   Kidney dialysis.
  •   Chronic infection.
  •   Cancer and cancer treatment.

The acute phase of Wernicke’s encephalopathy is usually reversible through treatment, but it can progress to the chronic stage of Korsakoff’s syndrome if it is ignored, missed or otherwise left untreated. 

The acute phase can also be potentially life-threatening, especially if not treated quickly.


The Common Signs and Symptoms of Wet Brain Syndrome

The signs of wet brain syndrome can look different depending on how advanced the condition is.

For the acute stage, symptoms can include:

  • Confusion.
  • Loss of memory activity.
  • Loss of muscle coordination and leg tremors.
  • Double vision, abnormal eye movements or eyelid drooping.

If the condition progresses to the chronic stage (Korsakoff’s syndrome), the symptoms can be similar to dementia. The main symptoms are problems in acquiring new information or establishing new memories, as well as retrieving previous memories.

Signs of this stage of wet brain syndrome that others might notice could include:

  • Changes in personality, such as becoming apathetic, repetitive or more talkative.
  • Filling in gaps in the memory with things that didn’t happen.
  • Problems with concentration and decision-making.

It’s also worth noting that symptoms of a thiamine deficiency might show up before it progresses to any stage of wet brain syndrome.

Symptoms of a B1 deficiency can include (but are not limited to):

  • Loss of appetite.
  • Constipation.
  • Fatigue.
  • Blurry vision.
  • Changes in heart rate.
  • Irritability.
  • Nausea and vomiting.
  • Reduced reflexes and tingling sensation in the arms and legs.
  • Shortness of breath.
  • Muscle weakness.


Diagnosis of Wet Brain Syndrome

Wet brain syndrome is generally diagnosed based on a clinician’s interpretation of the symptoms and patient history, as there are currently no clinical tests to definitively show that a person has developed the condition. 

Some tests, such as routine laboratory screening and liver function tests, can help rule out other conditions with similar symptoms. However, tests that measure thiamine and erythrocyte transketolase activity – both of which are reduced in WKS – may also help a diagnosis.

Because diagnosis requires a physician’s best judgement, it is important that they have the correct information regarding the patient’s alcohol consumption.


Treatment and Prevention of Wet Brain Syndrome

Treatment options for wet brain syndrome may include synthetic vitamin B1 as well as helping them to stop drinking completely. If this is done during the acute stage, it may stop the condition from progressing. If it reaches the chronic stage, however, treatment can sometimes only prevent the condition from deteriorating further.

Alcohol detoxification treatment and a comprehensive rehabilitation programme can help the patient to stop drinking in the long term, which is a crucial part of treatment for wet brain syndrome. A nutritional programme will also help the patient to build up their vitamin B1 as well as encourage a healthier overall lifestyle.

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