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Treatment involves replacement of thiamine and providing proper nutrition and hydration. Intravenous thiamine is the treatment of choice. After the initial dose, daily doses of thiamine are usually recommended. Supplementation of electrolytes, particularly magnesium and potassium (often low in people with alcoholism), may be required in addition to thiamine. In those who are chronically malnourished, the remainder of the B vitamins also should be supplemented. Supplementation can be tapered as the patient resumes normal intake and shows improvement.Because long-term alcohol use is the most common cause for Wernicke-Korsakoff syndrome, avoiding alcohol provides the best chance for recovery. Referral to an alcohol recovery program should be part of the treatment regimen.
Due to difficulties with movement, patients should be provided with assistance when walking during the initial phase of treatment. Patients may require physical therapy to assist with movement. Walking difficulties may be permanent, depending on the severity at initial presentation and the timeliness of therapy.
Patients with Korsakoff syndrome rarely recover. Many patients require at least some form of supervision and social support, either at home or in a chronic care facility. There are some reports of improvement in attention and memory with the use of medication known as acetylcholinesterase inhibitors and with memantine, but nothing is yet confirmed.
- Dugdale DC. Wernicke-Korsakoff syndrome. MedlinePlus. February, 2014; http://www.nlm.nih.gov/medlineplus/ency/article/000771.htm.
- NINDS Wernicke-Korsakoff Syndrome Information Page. National Institute of Neurological Disorders and Stroke (NINDS). 2016; http://www.ninds.nih.gov/disorders/wernicke_korsakoff/wernicke-korsakoff.htm.
- Xiong GL. Wernicke-Korsakoff Syndrome. Medscape Reference. April 18, 2016; http://emedicine.medscape.com/article/288379-overview#a7.
- Charness ME. Overview of the chronic neurologic complications of alcohol. UpToDate. May 17, 2012; http://www.uptodate.com/contents/overview-of-the-chronic-neurologic-complications-of-alcohol.
- So YT. Wernicke encephalopathy. UpToDate. May 05, 2015; http://www.uptodate.com/contents/wernicke-encephalopathy.
- The Centers for Mendelian Genomics program is working to discover the causes of rare genetic disorders. For more information about applying to the research study, please visit their website.