Clinical Medicine Research 2015; 4(2-1): 15-23 Published online February 6, 2015 (http://www.sciencepublishinggroup.com/j/cmr) doi: 10.11648/j.cmr.s.2015040201.13 ISSN: 2326-9049 (Print); ISSN: 2326-9057 (Online) Alcohol induced neurocognitive impairment (wernicke - korsakoff): A hidden syndrome Prabhoo Dayal 1, * , Ankur Sachdeva 1 , Mina Chandra 2 , Kishore Hindustani 3 , Kuljeet Singh Anand 4 1 National Drug Dependence Treatment Centre (WHO Collaborating centre), All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi-110029, India 2 Department of Psychiatry and Drug De-addiction, Post Graduate Institute of Medical Education & and Research (PGIMER) and Dr Ram Manohar Lohia Hospital, New Delhi-110001, India 3 Department of Psychiatry, VMMC and Safdarjang Hospital, New Delhi, India 4 Department of Neurology, Post Graduate Institute of Medical Education & and Research (PGIMER) and Dr Ram Manohar Lohia Hospital, New Delhi-110001, India Email address: drpd@rediffmail.com (P. Dayal) To cite this article: Prabhoo Dayal, Ankur Sachdeva, Mina Chandra, Kishore Hindustani, Kuljeet Singh Anand. Alcohol Induced Neurocognitive Impairment (Wernicke - Korsakoff): A Hidden Syndrome. Clinical Medicine Research. Special Issue: Recent Research in Dementia. Vol. 4, No. 2-1, 2015, pp. 15-23. doi: 10.11648/j.cmr.s.2015040201.13 Abstract: Wernicke’s encephalopathy (WE) is an acute neuro-psychiatric syndrome due to inadequate supply of thiamine (vitamin B1) to the brain which leads to significant morbidity and mortality. Although alcohol use is the most common predisposing factor but Wernicke’s encephalopathy can occur in any patient with nutritional deficiency conditions such as hyperemesis gravidarum, hemodialysis, malignancy, use of total parenteral nutrition without adequate thiamine, and abdominal surgery. In a developing country, there are more chances of thiamine deficiency, because of poor intake of nutrients in routine diet due to economic reasons and local customs and cultural practices concerning the processing and cooking of rice and other foodstuffs. The national household survey of drug use in India (2004) found prevalence of alcohol use in about 21.4% of male population between 18-40 age group. Most of the emergency physicians and general practitioners are not well sensitized about neuropsychiatric disorders in patients with alcohol use disorders. Such patients are still under diagnosed. Till date, no such studies are available about treatment of wernicke-korsakoff syndrome in Indian population. Educating clinicians, specially emergency physicians about evaluation and treatment of Wernicke-Korsakoff syndrome is as important as to educate people to eat well balanced, mixed diet containing thiamine rich food as most of these patients receive emergency treatment but are frequently unrecognized. If undiagnosed or inadequately treated, it is likely to proceed to Korsakoff syndrome. Therefore best treatment for Wernicke-Korsakoff syndrome is prompt diagnosis and adequate treatment. Keywords: Alcohol, Wernicke’s encephalopathy, Thiamine (Vitamin B1), Korsakoff Syndrome, Neurocognitive Impairment, Treatment 1. Introduction Wernicke’s encephalopathy (WE) is an acute neuro- psychiatric condition caused by an inadequate supply of thiamine (vitamin B1) to the brain. Carl Wernicke described this distinctive entity in 1881 as acute superior hemorrhagic polioencephalitis .It involves an acute Wernicke- encephalopathy phase, followed by the development of a chronic Korsakoff's syndrome phase. Although WE and KS were discovered separately, these two syndromes are usually referred to under one name, Wernicke-Korsakoff syndrome, due to the fact that they are part of the same etiology and because the onset of KS usually follows WE if left untreated. The link to thiamine deficiency as a causative factor was discovered approximately 50 years later in the 1940s by Campbell and Russell (1). According to autopsy-based studies, the disorder is still greatly under diagnosed in adults. Although alcoholism is the most common predisposing factor but Wernicke’s encephalopathy may occur in any patient with nutritional deficiency conditions such as hyperemesis gravidarum, hemodialysis, malignancy, use of total parenteral nutrition