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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.

Prognosis

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 cognitive skills) may be permanent. There may be a need for custodial care if the loss of cognitive skills is severe. Other disorders related to the abuse of alcohol may also be present.

Complications

Permanent loss of memory.
Permanent loss of cognitive skills.
Injury caused by falls.
Difficulty with personal or social interaction.
Alcohol withdrawal state.
Permanent alcoholic neuropathy.
Shortened life span.
Wernicke´s encephalopathy may be precipitated in at-risk people by carbohydrate loading or glucose infusion. Supplementation with thiamine must precede glucose infusion to prevent this.

Call Your Health Care Provider If:

Call your health care provider if Wernicke-Korsakoff syndrome is present and symptoms worsen or reappear. Also call if new symptoms develop, including symptoms of alcohol withdrawal: