How is Wernicke-Korsakoff syndrome (WKS) prevented?

Updated: May 16, 2018
  • Author: Glen L Xiong, MD; Chief Editor: David Bienenfeld, MD  more...
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Answer

Long-term alcohol use is the most common etiology for the development of Wernicke-Korsakoff syndrome. Abstinence from alcohol, in conjunction with thiamine replacement, provides the best chance for recovery. Refer patients for alcohol abuse counseling, community alcohol abuse treatment programs (eg, Alcoholics Anonymous and other consumer support programs), and couples/family therapy on an individual basis to deter future alcohol use and prevent future episodes of Wernicke-Korsakoff syndrome.

In patients at risk for malnutrition (eg, after gastric bypass surgery), appropriate thiamine and other B-vitamin supplementation should be taken in accordance with a nutritionist’s advice.

In emergency management of patients with acute confusion and concurrent risk factors (eg, alcohol dependence and malnutrition), thiamine administration should be strongly considered, especially prior to glucose administration. [54] Generally, high-carbohydrate diets increase the demand for thiamine. [34]  Immediate intravenous thiamine supplementation is the standard of care in ER patients with alcohol use disorders and withdrawal, and should be strongly considered in anyone with malnutrition.

In a large, prospective study, the introduction of thiamine-enriched bread flour was shown to reduce the prevalence of Wernicke-Korsakoff syndrome in Australia. [55] However, whether thiamine fortification in general or additional supplementation in alcoholic beverages could reduce Wernicke-Korsakoff syndrome has not been systematically studied.


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