People who drink alcohol regularly and for long periods are at risk of developing alcoholic encephalopathy. Alcoholic encephalopathy is a condition where a person’s thinking becomes impaired from long-term alcohol abuse; it is also known as Wernicke’s encephalopathy.

Wernicke’s encephalopathy can develop in anyone that does not get enough Vitamin B1 (thiamine) in their diet, but it is most common in people with alcohol use disorder (AUD).

Alcohol impacts vitamin B1 levels in two ways: first, it decreases how much thiamine is absorbed in the gastrointestinal tract (GI tract); second, people with AUD tend to have poor diets low in thiamine.

Alcoholic encephalitis is more likely to happen to people that drink excessive alcohol for years. People who occasionally drink or even drink moderate amounts are not at risk of alcoholic encephalopathy.

What is Wernicke’s Encephalopathy?

Wernicke’s encephalopathy is the medical term for alcoholic encephalopathy — they refer to the same condition.

The terminology may be confusing because Wernicke’s encephalopathy is part of a larger condition called Wernicke Korsakoff Syndrome (WKS).

When someone develops thiamin deficiency from alcohol abuse; they usually experience two different conditions as part of WKS.

  • Wernicke’s encephalopathy (WE)

    Encephalopathy is acute and life-threatening and can lead to permanent brain damage. Symptoms may look similar to alcoholic intoxication but are not the same thing. Hallmarks of encephalopathy that help distinguish it from intoxications are abnormal eye movements and muscle twitching. During WE, brain cells are not able to process fuel because they do not have enough thiamin to do so. Damage from WE can be permanent if not treated immediately.

  • Korsakoff syndrome (KS)

    KS is the permanent consequence of WE, and symptoms may be worse if it took longer to get the person medical attention. Symptoms of KS are an inability to form new memories, making up stories, loss of memory and hallucinations. KS damage cannot be reversed.

Described together, WE and KS are called Wernicke-Korsakoff Syndrome.

Alcoholic Encephalopathy Symptoms

Alcoholic encephalopathy symptoms may include:

  • Abnormal eye movements and eyelid drooping
  • Alcohol withdrawal symptoms
  • Coma
  • Confusion and decreased mental activity
  • Death
  • Loss of muscle coordination
  • Tremors

Since symptoms of WE are so similar to alcohol intoxication, it is important to understand hallmark symptoms. The most obvious and common signs of WE are abnormal eye movement, loss of muscle coordination and tremors. People with encephalopathy are usually confused in a way that is not normal for them or their drinking habits.

People at risk of developing WE tend to be people with severe AUD who drink alcohol most days and in high amounts. They have usually developed a tolerance, and alcohol does not cause the symptoms of confusion and impairment as it does for other people.

Alcoholic Encephalopathy Prognosis

Encephalopathy will get worse without treatment and can be life-threatening. If a person receives prompt treatment, they can stop and sometimes reverse symptoms.

If someone is showing symptoms of WE, they should be taken to the hospital.

Alcoholic Encephalopathy Treatment

Treatment consists of supplementing the person with thiamine.

Thiamine is usually not given by mouth because it will not absorb fast enough to be effective. To ensure the person absorbs thiamine quickly, it is injected into the muscle (intramuscular) or the vein (intravenous). Thiamine supplementation continues for several days while the person is stabilized by hospital staff.

To prevent WE, people who drink alcohol regularly should, at a minimum, supplement their diet with B-complex vitamins. The most effective prevention of WE is to stop drinking alcohol and maintain a healthy diet and lifestyle.