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What Is Wet Brain (Wernicke-Korsakoff Syndrome)?

“Wet brain,” which is technically referred to as Wernicke-Korsakoff syndrome, is a type of cognitive impairment. Its symptoms are similar to dementia. Wet brain is sometimes caused by excessive alcohol consumption (alcohol addiction). 

Wet brain syndrome results as a combination of two closely related conditions occurring simultaneously, known individually as Wernicke's encephalopathy and Korsakoff’s syndrome. 

With Korsakoff’s syndrome, more severe cases progress into Korsakoff’s psychosis. This syndrome is more problematic than milder cases of wet brain. While wet brain is a commonly used term, the medical term “Wernicke-Korsakoff syndrome” is used more widely today than it was in the past. 

What Causes Wet Brain?

The root cause of wet brain is thiamine deficiency. Thiamine, also known as Vitamin B1, is an essential vitamin that must be ingested. It cannot be produced like Vitamin D from the interaction between skin cells and sunlight. 

Every cell in the human body uses thiamine, which helps to process fats, proteins, and carbohydrates. It does this by breaking them down into glucose and, ultimately, energy in the brain, nerves, and heart. 

Drinking alcohol hinders the absorption of thiamine. It also diminishes thiamine reserves that are stored in the liver and interfere with the enzyme that activates its bioavailability.

On top of this, many people suffering from alcoholism have poor diets, which can further diminish thiamine levels in the body due to malnutrition 

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Alcohol Abuse & Wet Brain Syndrome

Wet brain syndrome is a condition that presents itself only after long-term use and abuse of alcohol. However, alcoholism alone cannot account for the onset of wet brain. It is a complex condition brought about by a multitude of factors, much like alcohol use disorder. 

Wet brain is also described as “alcohol-related dementia.” It causes damage to the parts of the brain responsible for learning and memory functions. This damage is often irreversible. 

Wet brain is sometimes difficult to diagnose. Its symptoms can resemble alcohol withdrawal or intoxication. Those suffering from the condition often lack a support system to aid in identifying and formally diagnosing the condition.

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Symptoms of Wet Brain

The symptoms of wet brain vary depending on the degree to which the brain has been affected. These symptoms include:

  • Appetite loss
  • Vomiting and persistent nausea
  • Exhaustion or fatigue
  • Weakness
  • Unexplained giddiness
  • Insomnia
  • Trouble concentrating
  • Confusion
  • A decrease in mental activity
  • Ataxia (loss of muscle coordination)
  • Brain damage, such as cognitive impairment, forgetfulness, and memory loss
  • Confabulation (fake memories created to replace real, forgotten memories)

In more severe cases, such as when Korsakoff’s psychosis is reached, the symptoms can include:

  • Changes in vision, such as double vision
  • Abnormal eye movements or eyelids drooping
  • Rapid heart rate
  • Inability to develop new memories
  • Severe memory loss
  • Visual and auditory hallucinations

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Complications of Wet Brain Syndrome

Untreated wet brain syndrome can lead to serious and increasingly harmful complications. The most severe of these complications is the progression into Korsakoff’s psychosis, where the brain is irreparably damaged and leads to increased memory problems. 

This often causes people to make up stories to fill in gaps, which sometimes are not even remembered by the person suffering from psychosis. In very severe cases, the physical complication of wet brain syndrome can lead to a loss of brain function that results in coma or even death.

Is Wet Brain Reversible?

It is possible to reverse the effects of Wernicke Korsakoff syndrome. Unfortunately, few make a full recovery. The severity of the case, how early treatment is started, and what type of treatment they receive will help determine whether symptoms of Wernicke Korsakoff syndrome can be alleviated or reversed.

Early intervention is the best way to increase the body's ability to restore normal function.

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Wet Brain Prognosis, Diagnosis & Treatment Options

The primary goal of diagnosing and treating wet brain syndrome is to lessen the symptoms and prevent the disorder from progressing into a worsened state. Wet brain needs to be treated as soon as possible.

Early-stage treatment can limit and even reverse the harmful effects that thiamine deficiency has on people suffering from the condition. There are three main methods for early-stage treatment, which should all be applied together:

  • Vitamin B1/Thiamine supplements
  • Abstinence from alcohol
  • Eating a well-balanced and nutritious diet

Part of what makes treating wet brain a challenge is that abstinence from alcohol is extremely difficult. Becoming sober and permanently giving up alcohol will prevent further losses in brain function and nerve damage. 

Addiction treatment, such as an intervention or medically-supervised detox at an inpatient treatment center, might be necessary to accomplish this. Alcohol withdrawal symptoms can be quite severe. And in some cases, deadly. It is important to take the proper steps to ensure one life-threatening condition is not swapped for another by quitting cold-turkey.

Once a proper detox is in place, and thiamine levels are elevated from Vitamin B1 shots, all that’s left to do is eat a nutritious and balanced diet. This ensures the effects of wet brain are mitigated to the extent that it is possible. 

Depending on the severity and stage of the condition, this could lead to a full recovery. However, it might only stop the syndrome from progressing even further. Either way, it will be an improvement over the devastating effects caused by untreated Wernicke-Korsakoff syndrome.

Unlike Alzheimer’s disease, WKS symptoms will not get worse over time if you undergo treatment early on.

Treatment Options for Alcohol Abuse & Addiction

There are many treatment options available for alcohol abuse and addiction, including:

  • Inpatient ProgramsInpatient treatment takes place at a licensed residential treatment center. These programs provide 24/7 comprehensive, structured care. You'll live in safe, substance-free housing and have access to medical monitoring. The first step of an inpatient program is detoxification. Then behavioral therapy and other services are introduced. These programs typically last 30, 60, or 90 days, sometimes longer. Most programs help set up your aftercare once you complete the inpatient portion of your treatment.
  • Partial Hospitalization Programs (PHPs) Partial hospitalization programs (PHP) are sometimes referred to as intensive outpatient programs (IOP). Compared to inpatient programs, partial hospitalization programs provide similar services. These include medical services, behavioral therapy, and support groups, along with other customized therapies. However, in a PHP you return home to sleep. Some services provide food and transportation, but services vary by program. PHPs accept new patients as well as people who have completed an inpatient program and still need intensive treatment.
  • Outpatient Programs Outpatient treatment is less intensive than inpatient or partial hospitalization programs. These programs organize your treatment session based on your schedule. The goal of outpatient treatment is to provide therapy, education, and support in a flexible environment. They are best for people who have a high motivation to recover and cannot leave their responsibilities at home, work, or school. Outpatient programs are often part of aftercare programs once you complete an inpatient or PHP program.
  • Medication-Assisted Therapy (MAT) Sometimes, medications may be used in alcohol addiction treatment. Some medicines can help reduce the negative side effects of detoxification and withdrawal. Others can help you reduce cravings and normalize body functions. Disulfiram (Antabuse), acamprosate (Campral), and naltrexone are the most common medications used to treat AUD. When combined with other evidence-based therapies (such as cognitive behavioral therapy), MAT can help prevent relapse and increase your chance of recovery.
  • Support Groups Support groups such as Alcoholics Anonymous and SMART Recovery are open to anyone with a substance abuse problem. They are peer-led organizations dedicated to helping each other remain sober. They can be the first step towards recovery or part of a long-term aftercare plan.

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Resources

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Centers for Disease Control and Prevention (CDC). Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). Average for United States 2006–2010 Alcohol-Attributable Deaths Due to Excessive Alcohol Use. Available at: https://nccd.cdc.gov/DPH_ARDI/Default/Report.aspx?T=AAM&P=f6d7eda7-036e-4553-9968-9b17ffad620e&R=d7a9b303-48e9-4440-bf47-070a4827e1fd&M=8E1C5233-5640-4EE8-9247-1ECA7DA325B9&F=&D=

World Health Organization (WHO). Global Status Report on Alcohol and Health. p. XIV. 2014 ed. Available at: http://www.who.int/substance_abuse/publications/global_alcohol_report/msb_gsr_2014_1.pdf?ua=1

Substance Abuse and Mental Health Services Administration (SAMHSA). 2018 National Survey on Drug Use and Health (NSDUH). Table 2.1B—Tobacco Product and Alcohol Use in Lifetime, Past Year, and Past Month among Persons Aged 12 or Older, by Age Group: Percentages, 2017 and 2018. Available at: https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect2pe2018.htm#tab2-1b.

Sacks, J.J.; Gonzales, K.R.; Bouchery, E.E.; et al. 2010 national and state costs of excessive alcohol consumption. American Journal of Preventive Medicine 49(5):e73–e79, 2015. PMID: 26477807, https://pubmed.ncbi.nlm.nih.gov/26477807/

Michael D. Kopelman, Allan D. Thomson, Irene Guerrini, E. Jane Marshall, The Korsakoff Syndrome: Clinical Aspects, Psychology and Treatment, Alcohol and Alcoholism, Volume 44, Issue 2, March-April 2009, Pages 148–154, https://doi.org/10.1093/alcalc/agn118

Arts, Nicolaas Jm et al. “Korsakoff's syndrome: a critical review.” Neuropsychiatric disease and treatment vol. 13 2875-2890. 27 Nov. 2017, doi:10.2147/NDT.S130078. https://pubmed.ncbi.nlm.nih.gov/29225466/
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