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. The goals of treatment are to control symptoms as much as possible and to prevent progression of the disorder.
Hospitalization is required for initial control of symptoms.
If the person is lethargic, unconscious, or comatose, monitoring and care appropriate to the condition may be required. The airway should be monitored and protected as appropriate. Thiamine does not generally improve loss of memory and intellect associated with Korsakoff psychosis. Total abstinence from alcohol is required to prevent progressive loss of brain function and damage to peripheral nerves. A well-balanced, nourishing diet is recommended.