Wernicke’s syndrome

Wernicke’s syndrome is a condition frequently occurring in alcoholics due to thiamine deficiency resulting from poor nutritional intake, alcohol-induced malabsorption on the small bowel and decreased production of the thiamine-dependent enzyme transketolase.

It is characterized by lesions in several parts of the brain, including the hypothalamus, mammillary bodies and tissues surrounding the ventricles and aqueducts, double vision, ophthalmoplegia, involuntary and rapid movements of the eyes, lack of muscular coordination and decreased mental function, which may be mild or severe.

The symptoms are usually of absorption onset and may occur slightly or in various combinations. Although it is most commonly associated with nutritional deficiency of chronic alcoholism, Wernicke’s syndrome has been reported with hemodialysis and gastric surgery for morbid obesity.
Wernicke’s syndrome

Wernicke-Korsakoff syndrome

Wernicke-Korsakoff syndrome is the classical manifestation of central nervous system (CNS) deficiency of thiamine caused by alcoholism.

S. S. Korsakoff was a 19th century Russian physician who observed amnesic patients with widespread brain damage from alcoholism.

Thiamine deficiency in alcoholic results from a combination of factors, including inadequate dietary intake, reduced gastrointestinal absorption, decreased hepatic storage and impaired use do thiamine.

Thiamine

Acutely, recent memory is impaired more severely than other metal tasks. In its acute stages, Wernicke–Korsakoff syndrome includes combinations of ataxia and ocular motility abnormalities, including conjugate gaze paresis, abducens nerve paresis, and nystagmus. However, only a minority of patients display all these abnormalities.

Not all alcoholics develop Wernicke-Korsakoff syndrome which suggest that genetic factors may be involved. The selective vulnerability to thiamine deficiency in different populations appears to be related to genetic variations of TK*(transketolase).
Wernicke-Korsakoff syndrome 

*TK is a key pentose phosphate shunt enzyme that plays an important role in the production of reducing equivalents and pentose sugars.