What is the initial approach to treatment for Wernicke-Korsakoff syndrome (WKS)?

Updated: May 16, 2018
  • Author: Glen L Xiong, MD; Chief Editor: David Bienenfeld, MD  more...
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Wernicke-Korsakoff syndrome (unlike acute Wernicke encephalopathy) is often a long-term condition. It should be treated aggressively as Wernicke encephalopathy in the acute setting, but with the understanding that it is rare for the Korsakoff amnestic state to fully reverse with treatment. After a course of treatment with high-dose parenteral thiamine and reversal of the acute effects of Wernicke encephalopathy, if there is no improvement in the Korsakoff amnestic state or other mental status abnormalities for 7 days, then a strategy of secondary harm prevention should be pursued. This includes maintenance with oral thiamine to prevent further insult, as well as consideration for rehabilitation, treatment of comorbid deficiencies and medical conditions, and consideration of the need for long-term residential care or supportive accommodation.

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