The onset is gradual. The syndrome is actually two disorders that may occur independently or together. It may also include symptoms caused by alcohol withdrawal . Korsakoff psychosis involves damage to areas of the brain.
History is significant for chronic alcohol use .
Reflexes may be decreased or of abnormal intensity, or abnormal reflexes may be present. Testing of gait and coordination indicate damage to portions of the brain that control muscle coordination. Examination of the eyes shows abnormalities of eye movement. A nutritional assessment may confirm malnourished state, serum B-1 levels may be low, pyruvate is elevated, and transhetolase activity is decreased. A cranial MRI rarely shows changes in the tissue of the brain indicating Wernicke-Korsakoff syndrome.