If Wernicke's encephalopathy is not recognised and treated early and adequately with parenteral administration of high-dose thiamine, patients can develop permanent neurological injury, manifested by impairment of recent and remote memory, apathy, and confabulation (a collection of signs and symptoms characterising Korsakoff's psychosis), along with persistent manifestations of Wernicke's encephalopathy, including ataxia and varying degrees of ophthalmoparesis.[3]Arts NJ, Walvoort SJ, Kessels RP. Korsakoff's syndrome: a critical review. Neuropsychiatr Dis Treat. 2017;13:2875-90.
https://www.dovepress.com/korsakoffs-syndrome-a-critical-review-peer-reviewed-fulltext-article-NDT
http://www.ncbi.nlm.nih.gov/pubmed/29225466?tool=bestpractice.com
[23]Sechi G, Serra A. Wernicke's encephalopathy: new clinical settings and recent advances in diagnosis and management. Lancet Neurol. 2007 May;6(5):442-55.
http://www.ncbi.nlm.nih.gov/pubmed/17434099?tool=bestpractice.com
Wernicke's encephalopathy has a mortality rate of up to 20%, although data on prognosis and mortality is scarce given that the condition is considerably underdiagnosed.[73]Ota Y, Capizzano AA, Moritani T, et al. Comprehensive review of Wernicke encephalopathy: pathophysiology, clinical symptoms and imaging findings. Jpn J Radiol. 2020 Sep;38(9):809-20.
https://link.springer.com/article/10.1007/s11604-020-00989-3
http://www.ncbi.nlm.nih.gov/pubmed/32390125?tool=bestpractice.com
[88]Manzo G, De Gennaro A, Cozzolino A, et al. MR imaging findings in alcoholic and nonalcoholic acute Wernicke's encephalopathy: a review. Biomed Res Int. 2014;2014:503596.
https://onlinelibrary.wiley.com/doi/10.1155/2014/503596
http://www.ncbi.nlm.nih.gov/pubmed/25050351?tool=bestpractice.com
[89]Sanvisens A, Zuluaga P, Fuster D, et al. Long-term mortality of patients with an alcohol-related Wernicke-Korsakoff syndrome. Alcohol Alcohol. 2017 Jul 1;52(4):466-71.
https://academic.oup.com/alcalc/article/52/4/466/3065162
http://www.ncbi.nlm.nih.gov/pubmed/28340112?tool=bestpractice.com
One nationwide study investigating the incidence and mortality of Wernicke-Korsakoff syndrome reported a standardised mortality ratio of 5.67 (95% CI 5.25 to 6.13) and observed most excess mortality were in alcohol-related cases.[24]Palm A, Vataja R, Talaslahti T, et al. Incidence and mortality of alcohol-related dementia and Wernicke-Korsakoff syndrome: A nationwide register study. Int J Geriatr Psychiatry. 2022 Aug;37(8):10.1002/gps.5775.
https://onlinelibrary.wiley.com/doi/10.1002/gps.5775
http://www.ncbi.nlm.nih.gov/pubmed/35789035?tool=bestpractice.com