Numerous neurological consequences of alcoholism have been identified, including hepatic encephalopathy, Wernicke encephalopathy, Korsakoff syndrome, Marchaifava–Bignami disease and central pontine myelinosis. Here, Zahr et al. focus on Wernicke encephalopathy and Korsakoff syndrome, exploring their position within a proposed spectrum of neurological disruption that begins with alcohol-related brain damage.