What is Wet Brain?: Causes, Symptoms, and Treatment

Key Points

When you have heard about people who are battling heavy drinking, you may have encountered the terms Wernicke-Korsakoff Syndrome or “wet brain.”

Wernicke-Korsakoff Syndrome is a condition caused by significant neurological dysfunction due to extremely low levels of thiamine (vitamin B1).[1]

Identifying the problem at the earliest possible time allows for treatment that can significantly reduce potential long-term damage. In many cases, when identified at onset, treatment will allow for prevention of potential long-term disability.

What is Wet Brain Syndrome?

Wet brain is another way people refer to Wernicke-Korsakoff syndrome. This is a medical term used to describe two interrelated neurologic disorders that typically appear sequentially: Wernicke encephalopathy, an acute and severe reaction to thiamine deficiency requiring emergency intervention, and Korsakoff syndrome, a chronic disorder with persistent memory deficits that may occur if the first phase of the disease is left untreated.[2]

These two conditions have been linked together as they both stem from the same etiology and both can occur in the same individual over time. While it is possible to experience Wernicke encephalopathy and not subsequently develop Korsakoff syndrome, the likelihood increases rapidly when the first stage of the disease is not treated promptly and appropriately.[3] This is why understanding the relationship between the two stages is essential in order to understand what a wet brain is and why immediate action needs to be taken.

How Does Continued Heavy Drinking Contribute to Wet Brain?

The Role of Thiamine (Vitamin B1)

The brain relies on thiamine to help turn nutrients into the energy it needs to function.[4]

This means all brain cells rely on a continuous supply of thiamine in order to perform their usual biochemical functions, and even short-term shortages can disrupt how the cells function. Since there are extremely limited amounts of thiamine stored in the brain, long-term deficiencies can lead to irreversible damage to the portions of the brain that control memory, motor movements, and eye coordination.[5]

Why Do People Who Drink Excessively Develop Thiamine Deficiencies?

Heavy drinkers’ bodies are unable to get or use enough thiamine due to multiple ways alcohol interferes with nutrition.[6]

1. Heavy drinkers often do not eat well, so they receive less than optimal amounts of thiamine.
2. Excessive drinking impairs the absorption of thiamine by the intestinal tract,
3. Excessive drinking impairs liver storage
4. Excessive drinking prevents conversion of thiamine into usable forms.

Collectively, all these factors render brain cells deprived of nutrients necessary for survival.

It Isn’t Just Alcoholism

While chronic alcohol abuse is the most common cause of thiamine deficiency leading to wet brain, there are other causes as well.[7] The most common include:

• Malnutrition
• Eating disorders
• Surgical removal of parts of the stomach (as in bariatric surgery)
• Cancer
• Inflammatory bowel disease
• Extreme morning sickness
• Other conditions that can lead to poor nutrient absorption or thiamine deficiency, including dialysis

The Two Stages of Wet Brain Syndrome

Wet Brain Syndrome has a two-stage progression, with each stage linked to the other.

If left untreated, Wernicke’s Encephalopathy will progress into Korsakoff’s Syndrome as more brain tissue is damaged.[8] Timing is very important because of this.

Thiamine given early during Stage 1 can halt the progression to Stage 2 and prevent the chronic memory deficits associated with Korsakoff’s Syndrome. Once Korsakoff’s Syndrome develops, it is possible that the damage done will be irreversible.[9]

Symptoms of Wet Brain

Early Symptoms (Wernicke Encephalopathy)

Signs of Wernicke encephalopathy tend to appear suddenly and may include:

• Confusion
• Difficulty concentrating
• Loss of balance
• Trouble walking
• Double vision
• Abnormal eye movements
• Drooping eyelids
• Drowsiness

Korsakoff Syndrome Symptoms

If Wernicke encephalopathy is not treated in time, signs of Korsakoff syndrome may develop, including:

• Severe short-term memory loss
• Difficulty learning new information
• Confabulation, or filling memory gaps without intending to deceive
• Personality changes
• Hallucinations, though this is less common
• Apathy
• Difficulty performing everyday tasks

Wet Brain Syndrome Diagnosis

Because there is no single definitive test to confirm wet brain syndrome, physicians rely on an array of diagnostic methods.[10] These include:

• A medical history of alcohol consumption
• A nutritional assessment
• A physical and neurological examination
• Cognitive testing
• Laboratory blood work (including thiamine level evaluations)
• Imaging studies using MRI or CT scans, primarily to determine if another condition exists

The late-stage symptoms of wet brain syndrome can resemble those experienced during alcohol withdrawal, dementia, or stroke.[11] Because of this, it is essential that family members and health care providers be aware of the distinct set of symptoms associated with this disorder.

Reversal of Wet Brain Syndrome Symptoms

Many people wonder if the condition can be reversed. The response varies depending upon when treatment begins. Some improvements in coordination, vision, and cognition have been reported in patients who received prompt treatment.

However, some residual effects remain post-treatment initiation and may continue indefinitely.[12] Examples include:

• Severe memory impairments
• Impairment in learning new skills
• Deficits in executive function, resulting in impaired planning, organization, and management of daily activities

While many individuals experience significant recovery and most prior cognitive abilities are regained, others experience persistent cognitive disabilities. Research reports that immediate thiamine supplementation and stopping alcohol consumption have the greatest impact on the likelihood of recovery.[13]

Can Wet Brain Syndrome Be Prevented?

Yes, and early prevention is key. When an individual’s risk factors are identified and treated promptly, they can take several preventive measures, including:

• Receiving early treatment for alcohol use disorders
• Eating well-balanced diets
• Taking thiamine supplements as directed by their physician (if they have a higher-than-normal risk)
• Getting medical treatment for continuous vomiting and malnutrition
• Identifying and reporting symptoms before permanent brain injury happens

Since timely intervention has such a significant impact on outcome, being aware of the risk factors listed above is a very effective tool.

When Should I Seek Emergency Care?

Wernicke encephalopathy is a medical emergency. Seek immediate care if someone who consumes excessive amounts of alcohol or suffers from malnutrition experiences any of the following:

• Confusion and disorientation
• Inability to walk
• Coordination loss
• Visual disturbances
• Abnormal eye movement patterns
• Excessive sleepiness
• Loss of consciousness

Individuals closest to someone experiencing the above will likely identify these changes first. Since prompt thiamine administration given within this time frame can help prevent irreversible brain damage, do not wait. It is always better to err on the side of caution.

Conclusion

Wet brain syndrome is a potentially debilitating yet treatable condition resulting from chronic and severe thiamine deficiency, primarily related to abuse of alcohol. Identifying symptoms early and treating them immediately can significantly affect an individual’s potential to recover.

If you or a loved one are finding your relationship with alcohol is becoming something hard to control, help is possible. Reach out to SOBA NJ today. Our admissions team is available to answer your questions, verify your insurance, and help you get on the road to recovery and living a healthier life.

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