Wernicke's Encephalopathy is a degenerative disease of the brain. It consists of a thiamine (vitamin B1) deficiency. It is a serious neurological disorder that include symptoms such as: muscle atrophy, cold or dry skin, short term memory loss, difficulty swallowing, double vision, abnormal eye movements, inability to form new memories, staggering walk, speech difficulty, or confabulation.
A change in mental status is the most common sign along with confusion, disinterest, or irritation.
Wernicke's was first diagnosed in 1881 by Dr. Carl Wernicke. He described it as, "a triad of acute mental confusion, ataxia, and opthalmoplegia."
Korsakoff Amnestic Syndrome is a later stage and is more chronic than the acute, Wernicke's stage. It constitutes memory loss and confabulation.
Wernicke's develops, largely, in chronic alcoholics, and also among people with prolonged starvation, hypermesis gravidarum, bariatric surgery, and people with HIV-AIDS.
Thiamine helps metabolize carbohydrates. A deficiency in thiamine may kills cells that are thiamine dependent. These cells or enzymes are largely incorporated in cerebral energy which may cause brain tissue damage. Wernicke's may be present among 0.8-2.8% of the general population and as high as 12.5% in the population of chronic alcoholics. Up to 80% of Wernicke's Encephalopathy may be undiagnosed.
Wernicke's is best visualized with an MRI with fluid attenuated inversion recovery. This will demonstrate abnormal hyper-intensity in the gray matter of the brain.
Treatment of Wernicke's includes starting a balanced diet and hydration, starting intravenous thiamin, oral thiamin, or even drug therapy.
Salen, Phillip (May 2010). Wernicke's Encephalopathy. Retrieved from http://emedicine.medscape.com/article/794583-overview.
Wernicke's Encephalopathy (n.d.). Retrieved from http://www.health-disease.org/neurology-disorders/wernickes-encephalopathy.htm
