Weirnike-Korsakoff Syndrome

[my2sons]

Anyone have any firsthand experience with this? Close family member was recently diagnosed with this by a psychiatrist. She apparently was a long term ETOH drinker with a recent binge, which she was hospitalized after with malnutrition, dehydration, severe electrolyte imbalance, needed blood tx for gastric ulcer, pancreatitis. Violent behavior on the regular nursing floor (DT's?) and a week of inpatient Psych. Now she's back home and doesn't remember events leading up to hospitalization and has obvious short term memory problems. She received 3 doses thiamine and MVI IV fluid in hospital, and continues to take vitamins at home. Wondering what the typical prognosis is. Is memory impairment permanent? I guess I'm understanding this disease as basically brain damage caused by thiamine deficiency since her ETOH damaged liver wasn't absorbing it and she was boozing instead of eating. Having trouble believing that she went from a "functioning alcoholic" (employed, taking care of herself) to being forgetful and dependent. Doc suggests that she will not be able to take care of herself anymore and recommends filing for disability ASAP. Any comments! Thank you.

[Nurse Ratched, RN]

http://www.healthcentral.com/mhc/top/000771.cfm

Good source on basic info. It presents similar to Parkinson's in a lot of ways. Not generally progressive, assuming the person stops drinking (which many do not) but whatever degree of memory impairment exists is usually permanent.

Hoping for the best for your family member.

[lucianne]

I was assigned to a patient with Wernecke-Korsakoff syndrome during my psych clinical and I will never forget her. We spent a lovely day together while she spun one wild story after another about her life. She was quite charming and interesting, but her dementia was severe and irreversible. She will never be able to take care of herself.

I think your understanding of the disease is pretty accurate from what I remember. I'm sorry your family is having to deal with this and hope you are able to find care for your relative.

[kids]

It took me a minute to remember what it is (has been a long time). My only experience with WK was one patient in her 70s that I took care of in the late 1980s. Due to co-morbidities the symptoms were totally masked.

(btw, it is spelled Wernicke-Korsakoff)

Medline also has some good info http://www.nlm.nih.gov/medlineplus/ency/article/000771.htm

Also, the Family Caregiver alliance has a less clinical fact sheet (with a printable version) that may be help your non-medical family members understand what has and is happening.

http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=580

[leslie :-D]

i've had a few patients with this type of dementia....it is indeed irreversible and very sad since it was preventable.

[PsychoGirl]

I just learned about this. Korsakoff's syndrome is caused by a thiamide deficiency commonly found in extreme alcoholics. It's characterized by SEVERE memory loss.

[Murt]

A very intresting one which i see on a regular basis.

Its basically caused because alcoholics get their calorie intake from alcohol and can go weeks without eating. The get a B- vitamin (thiamin) shortage which is involved in transforming sugar to a form that the brain can use.

When an alcoholic finally gets care its vital they get intra muscular Thiamin before they ingest sugar. Thats why dr's should allways give im Thiamin to any unconcious patient before giving iv glucose etc which if not done can cause severe brain damage.

Anyway the disease (or Thiamin deficency)is dignosed by nystagmus (shakey eye movements), memory loss, confabulations (impressive bullshitting).

Normally we give them im Thiamin daily for 21 days beause alcoholic have dificulty taking up per os as their stomachs take a few weeks/days to recover and be able to absorb it.

It not reversible but it wont neccesarily get worse, but they have to stop drinking. As ppl have mentioned they're normally very charming, happy patients.

[Texanna]

I was married to an alcoholic for a few months, lived with him for over a year and I believe he has this disease. We still talk although he moved back to his home state when I refused to talk to him for a few weeks. I believe since I've known him he has pretended to be sober but can sadly never go more than a few weeks without his vodka. He is a young man, 40, but drank heavily every day for 20 years. He also has epilepsy from a childhood TBI. What is going to happen to this man, I wonder. I think he shoudl be in a nursing home but his family was very hateful towards me when I tried to get them to help. I do not believe long term he can care for himself, he has no health insurance now, and lives alone, spends his days on the computer and compulsively shopping for bargains (buys things he doesn't need). One of his family members sends him money on a monthly basis, enough to pay rent, so he manages, but every few weeks he is back in the hospital, he has long periods of vomitting, not sleeping, not eating not caused from flu. His liver of course is damaged and probably his gall bladder as well. He will not drink and get sick and I guess his thought process is, heck, I am not drinking and I am still sick, it doesn't matter what I do, and then he goes back out again.

This is so sad. This is a lovely man. I truly care for him and have tried to extricate myself from this terrible situation, but I am afraid I just feel so sorry for him I take his calls when he tries to contact me. Is there help for someone like this? I cannot believe out of the 10 or so times he has been hospitalized over the past two years that a physician has not told him he has Korsakoff Syndrome and tried to treat him with thiamine. They always load him up on potassium and then in a week or so he is back to where he was.

Any thoughts would be appreciated. I will check out the websites mentioned in the thread above. Thanks and prayers are appreciated as well!

Texanna

[JeanettePNP, MSN, RN, NP]

If you've ever read Oliver Sack's The Man Who Mistook His Wife for a Hat, he has two chapters describing patients with Korsakoff's.

[Texanna]

I am trying to find a copy now. Thanks a million. This man's daughter is a nurse and I pray that she will recognize what is happening to him and get some help for him. He lives very near her but like many alcoholics isolates himself totally. I haven't heard from him in 4 days now...

T

[GalRN]

I've had acouple of pts with the disorder and remember them being pleasant but in lala land and could not care for themselves.

It's also near and dear to my heart b/c we are still wondering about my dad.... He had several psychotic episodes and had to be medically detoxed each time, starting at age 66. He is now 71, in LTC and can't remember what he ate for breakfast or anything else. They made a clinical diagnosis of Lewy body dementia, which can account for his mask face, recent shuffling and lack of spontaneous speech. However I think it's combined, a bit of each, he drank about a 6 pack a night (he's a little guy so that's a lot) every night for the last 50 yrs.

It breaks my heart, we were so close...

I also had no idea his alcoholism was as bad s it turned out to be. He never drank until us kids went to sleep....