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What is Wet Brain? Symptoms Every Heavy Drinker Should Know

One of the more serious impacts of alcohol on the brain is developing a serious brain disease known as “wet brain.” There are numerous ways that alcohol impacts the health of our brain, and this is one of the more fatal types.

We’ll discuss what brain is, how it is diagnosed, and the prognosis for individuals who develop it.

What is wet brain?

Wet brain is also known as Wernicke-Korsakoff syndrome. It’s a brain disease that affects people who frequently drink excessively. In fact, it primarily affects alcoholics. Wet brain from alcohol causes severe damage to the brain and happens in two stages: Wernicke Encephalopathy and Korsakoff Psychosis.

How does wet brain happen?

Wet brain from alcohol happens due to thiamine deficiency. This is a result of chronic alcohol abuse, but can also be caused by intestinal disorders or poor nutrition.

Alcohol inhibits the absorption of thiamine and reduces its usage in the body. It also causes the body to excrete more thiamine through urine than normal. Finally, chronic drinking causes an increased need for thiamine due to alcohol-related neuropathy (nerve damage).

Picture of a brain appearing to explode to symbolize brain damage from wet brain
understanding wet brain

Why Thiamine Deficiency is so Dangerous

Thiamine, also known as Vitamin B1, is important because is essential for carbohydrate metabolism and the normal function of the nervous system. It’s also a cofactor for the production of key enzymes that enable our brain to function properly. It protects cells and is critical for overall brain health.

The nervous system needs these enzymes to function, which is why thiamine deficiency from alcohol causes life-threatening neurological problems.

How long does it take to get wet brain?

Wernicke-Korsacoff syndrome happens quickly. Once thiamine levels in the brain drop, it takes about 4 days for cellular and tissue swelling to begin in the brain. Within 7 days, endothelial cells malfunction, leading to neuron death and increased permeability of the blood-brain barrier (high-risk factors for stroke). After 14 days, the brain damage is mostly irreversible and fatal.

Wet Brain Stage 1: Wernicke’s Disease

Wernicke encephalopathy is the first stage of wet brain syndrome. Symptoms include:

  • Confusion
  • Loss of muscle coordination and control–ataxia
  • Loss of memory, particularly short term memory loss
  • Sudden fatigue or drowsiness
  • Double vision or other problems with eyesight
  • Delirium Tremens
  • Abnormal eye movements
  • Loss of mental ability

Unfortunately, Wernicke’s Encephalopathy is difficult to diagnose, which makes catching it in time to treat it challenging. But this stage is critical. Early intervention increases the likelihood of recovery. If left untreated, however, patients can (and do) experience irreversible, life-altering brain damage.

How Wernicke’s Encephalopathy (WE) is Diagnosed

WE is typically diagnosed through clinical observation. The three classical signs doctors look for when making a diagnosis are:

  • Mental status change like the onset of memory problems, anxiety, confusion, irritability, disorientation, etc.
  • Ophthalmoplegia deals with the various eye-related signs of WE.
  • Ataxia – a catch-all term for various coordination and motor-function problems.

In addition to clinical observations, doctors will run lab tests for thiamine deficiency and may order an MRI to look for noticeable changes in the brain. However, MRI tests have a low sensitivity rate of 53%, making them an imperfect diagnostic tool.

Wet Brain Stage 2: Korsakoff Psychosis

Korsakoff Psychosis happens after a person has been through Wernicke’s Encephalopathy. It is the second and final stage of this deadly brain disease.

brain inside a glass of liquor with liquor bottles in the background
Wernicke-Korsakoff Syndrome

Why does Korsakoff Psychosis happen?

Korsakoff Psychosis happens when Wernicke’s Encephalopathy goes untreated. Approximately 80% of patients who get WE will go on to suffer from Korsakoff Psychosis. It can also occur as a result of severe or repeated Delirium Tremens from alcohol withdrawal. Additionally, Korsakoff Psychosis can occur as a result of a traumatic brain injury.

Korsakoff Psychosis Symptoms

Korsakoff Psychosis symptoms are characterized by two factors:

Confabulation – Involves telling stories with no basis in reality. Patients with Korsakoff Psychosis will often make up stories to fill memory blanks. They may also come up with made-up memories that convince them they have done or seen things that are simply not true.

Delusions – These are false ideas and beliefs that a person has, despite proof that the opposite is true.

In addition to these symptoms, patients with Korsakoff Psychosis often experience severe amnesia, dementia, and mood instability.

The combined diagnosis of these two stages is called Wernicke Korsakoff Syndrome (WKS).

Why Wernicke-Korsakoff is often not caught in time

In a study of Wernicke-Korsakoff Syndrome (WKS), 97 alcoholics whose autopsy confirmed WKS were observed. Of these 97 individuals, only 16% had documentation of all three classic symptoms. In the remaining cases, 29% had two signs, 37% had only one sign, and 19% presented none of the classic signs.

Another obstacle to early diagnosis is the fact that many symptoms of WKS mimic other illnesses and chronic conditions. It is sometimes difficult to differentiate between the early onset of Wernicke-Korsakoff Syndrome and alcohol withdrawal.

Additionally, a patient experiencing symptoms must seek medical treatment immediately in order to catch it in time for it to be treatable. Due to the rapid pace of deterioration in WKS patients, time is critically important.

80% of true cases of WKS are not diagnosed during life.

Source: https://www.sciencedirect.com/science/article/pii/S0033318212000771

Treatment for WKS

If full-blown WKS is caught early enough, doctors will typically treat it with intense thiamine replacement therapy for approximately 5 days. Tests will be run for additional nutrient deficiencies. Patients will likely receive these additional nutrients intravenously until the body is able to adequately absorb them on its own.

Additionally, doctors will monitor patients’ guts to ensure proper absorption and adjust their treatment plan accordingly. It can take several months for patients to experience a full recovery, which must be accompanied by improved nutrition and abstaining from alcohol.

Prognosis of Patients with Wet Brain

If a patient diagnosed with Wernicke’s Encephalopathy receives treatment right away, the prognosis is generally good. So long as they quit drinking alcohol and improve their diet, they should experience a full recovery.

However, once the patient enters stage 2, Korsakoff Psychosis, the outlook is less optimistic. Patients may experience some improvement with the initial treatment, but the remaining symptoms are likely permanent.

Approximately 80-90% of patients with Wernicke’s Encephalopathy will go on to develop Korsakoff Psychosis. This means prevention is the best tool for battling wet brain.

Because wet brain, or Wernicke-Korsakoff Syndrome, is so debilitating and fatal, it is important to take any symptoms you or your loved one may experience seriously. Additionally, you should know the signs of alcohol abuse and get treatment and recovery support before you sustain any further damage.

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A pinterest pin with a brain and a glass of wine and a beer bottle

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  1. After reading this, I’m almost positive that my ex has WET brain. The changes he has gone through over the years mentally and physically are shocking. I told my therapist that he’s unrecognizable now as the same person. He starts and ends his day with a drink. He’s brass and mean. His eyes don’t look like the same man. He’s also military but now only national guard. He refused to talk to me about PTSD or any issues he had. But he has become a full blown narcissist by the end of our relationship. He didn’t start that way and he didn’t drink as much either. With his denial I’m afraid I’ll just have to watch him fade away, because he won’t get help and he’s in the phase where if he isn’t drinking he has DT’s and is mean, anxious, and suspicious almost instantly. But as soon as he starts drinking, he accuses and belittles, bringing up past issues that have already been discussed multiple times. Then he’ll tell me how much he loves me and how I’m the only one in the world for him. There of course are many many more odd things in between and throughout. If I hadn’t watched him decline through the years, I’d just say he was a drunk. But it’s not just the alcohol. 😔