Wernicke-Korsakoff syndrome diagnostics and rehabilitation in the post-acute phase

Abstract

Severe addiction to alcohol can lead to malnutrition. Wernicke's Encephalopathy is an acute and preventable neuropsychiatric syndrome resulting from thiamine deficiency. The disorder is under-diagnosed and under-treated leading to chronic cognitive and motoric issues (Korsakoff syndrome). The acute and chronic phase combined are called Wernicke-Korsakoff syndrome. In this narrative review, we present an outline of Wernicke's Encephalopathy, and how Korsakoff's syndrome can be prevented in the acute and post-acute phase. We highlight novel insights into the post-acute medical care for motoric, psychiatric and cognitive sequalae and present a rehabilitation program aiming for optimal recovery based on both clinical and experimental evidence. We discuss proper diagnostics of Korsakoff's syndrome, and describe how to facilitate the transfer into the community and durable forms of long-term care. Prophylaxis of Wernicke's Encephalopathy is relevant, but the cure requires more than giving high doses of parenteral thiamine in the acute phase. Multidisciplinary diagnostics and care for handling delirium, ataxia, social limitations and reduced autonomy are required after WKS diagnosis. We emphasize the need for advanced diagnosis and treatment of overdue medical conditions in Wernicke's Encephalopathy, and for tailoring treatment programs with both compensatory and rehabilitation strategies for patients diagnosed with Wernicke's Encephalopathy.

Keywords

• Clinical nutrition
• Wernicke encephalopathy
• Korsakoff syndrome
• Neuropsychological assessment
• Multidisciplinary team