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What is Alcoholic Encephalopathy?

Laura M. Sands
Laura M. Sands

Alcoholic encephalopathy is brain damage caused by a thiamine deficiency. It is one of the most severe effects of long-term alcohol addiction. People with this condition are known to suffer from memory loss, permanent brain damage and a unique form of psychosis known as Korsakoff psychosis.

Also known as Wernicke’s disease or Wernicke-Korsakoff, alcoholic encephalopathy is characterized by hallucinations, double vision, a loss of smell, an unsteady gait and a severe loss of memory. Due to gaps in memory, a person with this condition may also be prone to make up stories and events in an attempt to camouflage a loss of recall. A person with alcoholic encephalopathy may also lose the ability to grasp new memories, which are necessary in the acquiring of learning new skills or the acquiring of new information.

Long-term alcohol addiction can cause alcoholic encephalopathy.
Long-term alcohol addiction can cause alcoholic encephalopathy.

Vitamin B1, also known as thiamine, is crucial to the brain’s normal functioning. Heavy alcohol use interrupts the body’s absorption of thiamine and, thus, creates a deficiency leading to brain impairment. Although supplemental doses of thiamine may help reverse some of the damage suffered from a deficiency, it does not eliminate all of the symptoms, such as memory loss.

Left untreated, alcoholic encephalopathy can lead to coma and death.
Left untreated, alcoholic encephalopathy can lead to coma and death.

The full effect of alcoholic encephalopathy tends to take place in two distinct stages. The first, known as Wernicke’s symptoms, occur during the acute phase of this condition and are characterized by symptoms such as gaps in memory and a loss of balance. The second stage, known as Korsakoff symptoms, is the chronic phase of this illness, which is characterized by a marked decrease in a person’s attention span, increased confusion, agitated behavior and impaired motor functioning. It is only after the onset and decline of acute Wernicke’s symptoms that chronic Korsakoff symptoms begin.

Alcohol abuse over a lengthy period of time can result in memory loss or permanent brain damage.
Alcohol abuse over a lengthy period of time can result in memory loss or permanent brain damage.

Alcoholic encephalopathy may still occur in individuals who attempt to eat balanced meals, but who continue to abuse alcohol. Long-term alcohol abuse impedes the body’s ability to properly absorb and assimilate thiamine normally found in food. Without proper absorption and assimilation, brain damage may still occur.

Alcoholic encephalopathy does not occur in all heavy alcohol users. Those afflicted with it, however, are sometimes permanently affected by its onset. Alcoholic encephalopathy can be treated if it is detected in its early stages, although a person may not recover from all of its effects. It is irreversible, however, if left untreated and if the person continues to consume alcohol. In many cases, alcoholic encephalopathy can even lead to coma and death.

Discussion Comments

anon327329

As a family member and caretaker of someone with this disease, it is worse than what you read about in these articles. And no, you don't have to get drunk every day to have it. It also comes from long-term alcohol use, like having your evening drink every day after work.

My mother has this disease. She is 72 and her brain atrophy looks like someone who is 112. She can no longer walk, talk or write. And her mind is still sharp. For her, it's like being trapped inside of her own body. She can't communicate or do anything for herself. She started with confusion and forgetting how to do things. Next came the constant falls (10 to 15 a week). Her eyes hurt all of the time and her vision is very poor. Her speech became slurred and eventually indecipherable. She can't feed herself anymore or brush her own teeth. I can't even begin to imagine what her frustration is like for her.

She can no longer go to any family functions. She doesn't want to be around anyone else because of her symptoms. She drools all of the time and her nose runs like a water faucet.

Please know that this is very real. It's awful for the person with it and for those caring for them. And this can last for many, many years. She was diagnosed seven years ago, and that was after the physical symptoms started.

Azuza

@JaneAir - I actually have a really hard time sympathizing with people with alcoholic encephalopathy. If you drink all day, every day, for years and years, what do you think is going to happen? You're going to be in perfect health? I do share your sympathy for family members though.

That being said, I'm pretty sure I used to know someone with this condition. We had a regular customer at one of the restaurants I used to work at who would always show up drunk, no matter what time of day it was.

Eventually he got sober, but you could really tell he wasn't all there. He had a lot of the symptoms described in the article and his memory was terrible. He made stuff up, a lot. I'm not sure what happened to that guy since I quit working there, but I imagine his condition hasn't improved much.

JaneAir

This sounds awful. And of course, there is a big barrier to treating this condition because many alcoholics have relapses and keep drinking. This further damages their brains and probably makes treatment impossible.

Also, a lot of alcoholics don't eat enough, or sometimes hardly at all. If you're constantly drunk, making sure your body gets adequate nutrients is probably the farthest thing from your mind.

I know alcoholics pretty much do it to themselves, but alcoholism is really a disease. I especially feel sorry for family members affected by this disease. It's probably worse for the family members to watch someone go through alcoholic encephalopathy than it is to actually have it.

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    • Long-term alcohol addiction can cause alcoholic encephalopathy.
      By: kmiragaya
      Long-term alcohol addiction can cause alcoholic encephalopathy.
    • Left untreated, alcoholic encephalopathy can lead to coma and death.
      By: Claudio's Pics
      Left untreated, alcoholic encephalopathy can lead to coma and death.
    • Alcohol abuse over a lengthy period of time can result in memory loss or permanent brain damage.
      By: Andres Rodriguez
      Alcohol abuse over a lengthy period of time can result in memory loss or permanent brain damage.
    • Heavy alcohol use can lead to brain impairment, interrupting normal functions.
      By: kiatipol
      Heavy alcohol use can lead to brain impairment, interrupting normal functions.
    • Alcoholic encephalopathy may cause double vision.
      By: JPC-PROD
      Alcoholic encephalopathy may cause double vision.
    • Someone with alcoholic encephalopathy may experience sensory hallucinations.
      By: Kirill Kedrinski
      Someone with alcoholic encephalopathy may experience sensory hallucinations.
    • Severe loss of memory may be a sign of alcoholic encephalopathy.
      By: annawin
      Severe loss of memory may be a sign of alcoholic encephalopathy.
    • Alcoholic encephalopathy is characterized by an unsteady gait.
      By: marilyn barbone
      Alcoholic encephalopathy is characterized by an unsteady gait.