Wet Brain Definition

Wet brain, also referred to as Wernicke-Korsakoff syndrome, is a brain disorder resulting from vitamin B (thiamine) deficiency. The condition is commonly seen in individuals suffering from alcohol use disorders (AUD). Wet brain requires medical treatment, which often includes thiamine supplements.

Wernicke-Korsakoff syndrome, also commonly known as wet brain, is a disease that affects the brain, memory, vision and coordination. It stems from a nutritional deficiency in thiamine (Vitamin B). Vitamin B helps the brain turn sugar into energy, which is needed for the brain and nervous system to function properly. Not having enough can lead to the two stage disease, Wernicke-Korsakoff syndrome.


What is wet brain

Stages of Wernicke-Korsakoff syndrome

Wernicke-Korsakoff syndrome comprises Wernicke encephalopathy and Korsakoff’s syndrome. It can be considered stages of the same disease. Though not all will experience both stages of the disease process.  

  • Wernicke encephalopathy: Wernicke encephalopathy is an acute brain reaction to thiamine deficiency. It is a life-threatening medical emergency. Symptoms can be both physical and mental. This includes vision issues, problems with balance, movement and confusion. Failing to treat the condition can lead to the onset of Korsakoff syndrome.
  • Korsakoff’s syndrome: Korsakoff’s syndrome is a memory disorder in which damage occurs to nerve cells, supporting brain cells and the spinal cord. Like Wernicke encephalopathy, it results from a lack of thiamine in the system. For most, Korsakoff’s syndrome is preceded by an episode of Wernicke encephalopathy. Wernicke symptoms may start to fade as Korsakoff’s begins. Although some may only experience Korsakoff’s syndrome without a preceding episode of Wernicke encephalopathy. Korsakoff’s syndrome involves memory difficulties. A person with Korsakoff’s syndrome may struggle with long-term and/or short-term memory and other cognitive tasks. They may experience long gaps in memory, struggle to remember conversations/facts later and confabulate. Confabulating is when a person unintentionally lies and makes up information or explanations for things they don’t remember. Hallucinations may also occur. 


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Wet brain signs & symptoms

Wernicke-Korsakoff syndrome often presents with a clinical triad of markers: altered mental status, nystagmus (or ophthalmoplegia), and ataxia. However, not all patients will have all three. Only about a third of those with the disorder present with the complete triad. In non-clinical terms, the following symptoms can be indications of Wernicke-Korsakoff syndrome:

  • Amnesia
  • Memory loss
  • Issues with executive function
  • False memories (confabulation)
  • Hallucinations
  • Confusion, agitation & anger
  • Apathy, affective & social-cognitive impairments
  • Vision problems
  • Speech issues
  • Gait abnormalities such as a wide-based or a short-stepped gait 
  • Problems standing without help

Not all symptoms will present all patients. Symptoms can vary depending on the stage and progression of the disorder. For instance, agitation, anger, hallucinations, and false memories are more likely to present at later stages (Korsakoff’s syndrome). 


Who is at risk for a wet brain?

Anyone can suffer from wet brain, but some groups are more likely than others to live a lifestyle that results in thiamine deficiency, the cause of the disease. The worldwide prevalence of Wernicke-Korsakoff syndrome is estimated to be between 0-2%.  However, people in the following groups may have a higher likelihood of developing the brain disorder:

  • People with alcohol use disorders
  • Homeless populations
  • Elderly
  • Individuals living in isolation
  • Psychiatric inpatients

There are also several situations and medical conditions that put people at higher risk for thiamine deficiency, therefore, increasing their risk of developing wet brain. These include:

  • Terminal cancer and terminal malignancies
  • Poor nutrition, malnutrition, restricted diets, starvation and anorexia nervosa
  • Malignancies of the gastrointestinal (GI) tract, bowel obstructions and inflammatory bowel disease
  • Bariatric surgery patients
  • Mothers breastfeeding without supplements
  • Those with systemic disorders including tuberculosis, uremia and AIDs

How wet brain is diagnosed

Wernicke-Korsakoff syndrome is diagnosed based on a physician’s judgement, as there is no one test to confirm the brain disease. A doctor will evaluate symptoms, conduct a physical exam, analyze the patient’s medical history and order a variety of tests and labs. These include memory screenings, cognitive tests, labs to determine thiamine levels, eye exams and walking tests.

In some cases, identifying wet brain in alcoholics can present a challenge, as some symptoms can be confused with symptoms of intoxication, withdrawal or an accident. To rule out other causes of symptoms, like a stroke, doctors often conduct imaging and additional testing.


Alcohol abuse and wet brain

Long-term, heavy alcohol abuse is the most common cause of Wernicke-Korsakoff syndrome. Though the condition is most likely to affect males over the age of 45 who are heavy drinkers, women and younger age groups can also develop wet brain. There are several reasons why people who suffer from alcohol use disorders are more likely to develop wet brain syndrome. 

Excessive alcohol abuse can lead to brain damage both directly and indirectly. Long-term alcohol abuse can affect how the body uses, absorbs and holds thiamine. Lifestyle factors can also lead individuals with alcohol use disorders to get less vitamin B in their diet. Additionally, some of the groups who are already at risk for thiamine deficiency may be more likely to have an alcohol use disorder as well, further increasing the possibility of the brain disorder. 


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Can Wernicke-Korsakoff syndrome be treated?

There are treatment options available that can reverse some of the symptoms of Wernicke-Korsakoff syndrome. When symptoms of Wernicke encephalopathy appear, emergency treatment should be sought immediately. Once detected, wet brain should be treated quickly and aggressively. If it is caught and treated early, during the acute stage of Wernicke’s encephalopathy, there is a higher likelihood that the condition can be fully reversed. 

Likewise, if you or a loved one presents symptoms of Korsakoff’s syndrome, the later stage of the condition, you should immediately go to a medical provider. Treatment can help improve symptoms or prevent them from worsening. However, once Korsakoff’s syndrome develops, even with treatment, it is rare that the amesnetic state will fully reverse as improvements in memory take time and can be incomplete. Successful treatment also often requires heavy alcohol users to stop drinking, as long term alcohol abuse can worsen the condition and cause additional brain damage.


Treatment for wet brain

Prevention and treatment for wet brain

If you or a loved one is displaying wet brain symptoms, it is extremely important to seek medical attention immediately. Seeking immediate treatment can reverse and help prevent a further progression of Wernicke-Korsakoff syndrome. Without treatment, wet brain can be a life-threatening, debilitating condition. 

To prevent additional damage to brain cells and further losses of function:

  • Seek medical attention immediately. Do not wait for the disease to progress.
  • Take thiamine supplements according to doctors’ instructions.
  • Stop drinking alcohol.
  • Consider seeking treatment for an alcohol use disorder.
  • Eat a balanced diet that provides sources of vitamin B .

Treatment for the condition often involves thiamine replacements as well as ensuring the patient is getting proper nutrition in their diet and hydrating. For the first 3 to 7 days, thiamine may be introduced intravenously or intramuscularly. Following this, patients are usually prescribed oral thiamine supplements, in some cases, indefinitely. Depending on the severity of a patient’s symptoms and their recovery, they may also require rehabilitation, treatment for other comorbid conditions and even long-term care. 

The importance of treatment for alcoholism

Because heavy alcohol abuse is a key cause of Wernicke-Korsakoff syndrome, to recover and prevent the disorder from worsening, it is important to stop heavy alcohol use. However, stopping when you are dependent on a substance is not always so easy. Alcohol use disorders are medical conditions and, like any other disease, often require professional treatment and management.  Seeking treatment for an alcohol use disorder can help one recover from wet brain, as well as the many other problems caused by alcohol abuse. 


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If you are considering addiction treatment for yourself or someone in your life, now is the time to take action. Addiction is a deadly disease that has taken too many lives, broken up families and destroyed futures.  Liberty Ranch offers free consultations. Call 888-387-1531 to talk to a specialist to help you select the right program for you.


Recognizing the brain disorder early means that medical treatment can be sought before the disease progresses, preventing life-long complications for some. Yet, many alcohol abusers are unaware of the disease and therefore may fail to seek proper medical treatment. In fact, sometimes wet brain is only detected because an individual chose to seek treatment for their alcohol use disorder and addiction professionals recognized the symptoms. These are not the only benefits of attending rehabilitation for substance use disorders.  Other health conditions caused by chronic alcohol abuse like other brain disorders, liver damage, heart disease and cancer may also be avoided, reversed or prevented from worsening.  Moreover, those struggling with addiction can heal and rebuild healthier, happier and more productive lives.


Liberty Ranch Rehabilitation Center

Recovering from an alcohol use disorder is not easy, especially alone or without proper support.  Alcoholism is a disease that can cause long-term damage to a person’s health, relationships, finances, loved ones and future. Nonetheless, recovery is possible. Like any other medical condition, alcohol use disorders require professional, evidence-based treatment from trained, experienced professionals.

At the Liberty Ranch Rehabilitation Center, our addiction specialists have been helping individuals with substance use disorders successfully recover and rebuild their lives for over 25 years.  The Liberty Ranch Rehabilitation Center offers clients a comprehensive Intensive Outpatient Program (IOP) based around addiction science and proven 12-step principles.  Medical management, treatment for comorbid conditions, individual, group and family counselling services are available to clients. We recognize that alcohol use disorders are complex and getting sober is just the first step in the recovery process. Liberty Ranch helps clients build the behavioral and emotional tools needed to sustain long-term sobriety.