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by Scholten A

Definition

Wernicke encephalopathy is a brain disease. It can lead to confusion, poor muscle control, and other problems. If left untreated, it can get worse and even be fatal.

The Brain
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Causes

Wernicke encephalopathy is caused by low thiamine (vitamin B1) levels. This may be due to a poor diet, problems absorbing vitamins, or both.

Risk Factors

Wernicke encephalopathy is most common in people with alcohol use disorder. Other things that raise the risk are:

  • Cancer and cancer treatments
  • Severe vomiting
  • Poor diet
  • Eating disorders
  • Digestive problems and surgeries, such as gastric bypass
  • Other diseases, such as AIDS, kidney diseases, infections, and thyroid disease
  • Dialysis

Symptoms

Symptoms may be:

  • Mental changes, such as:
    • Confusion
    • Problems staying focused
    • Memory loss
  • Vision problems
  • Problems walking and sitting

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

A blood test can check thiamine levels.

Treatment

Wernicke encephalopathy needs to be treated right away. Most symptoms will fade with treatment. Memory problems may continue.

Thiamine needs to be brought to normal levels quickly. Treatment involves:

  • Giving thiamine—through IV or injections
  • Keeping thiamine levels normal with:
    • Thiamine supplements
    • A diet rich in thiamine
  • Treatment for alcohol abuse disorder or eating disorders

Prevention

To reduce the risk:

  • Eat foods high in thiamine, such as:
    • Lentils and peas
    • Cereal—with added vitamins
    • Pecans
    • Spinach
    • Oranges
    • Milk and eggs
  • Limit alcohol or treat alcohol abuse disorder.

RESOURCES

National Institute of Neurological Disorders and Stroke  https://www.ninds.nih.gov 

National Institute on Aging  https://www.nia.nih.gov 

CANADIAN RESOURCES

Alzheimer Society Canada  http://www.alzheimer.ca 

Public Health Agency of Canada  https://www.canada.ca 

References

Alcohol-related brain damage (including Korsakoff’s syndrome). Alzheimer’s Society website. Available at: https://www.alzheimers.org.uk/info/20007/types%5Fof%5Fdementia/14/alcohol-related%5Fbrain%5Fdamage%5Fincluding%5Fkorsakoffs%5Fsyndrome. Accessed March 2, 2021.

Sinha S, Kataria A, Kolla BP, et al. Wernicke encephalopathy-clinical pearls. Mayo Clin Proc. 2019;94(6):1065-1072.

Wernicke encephalopathy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/wernicke-encephalopathy. Accessed March 2, 2021.

Wernicke-Korsakoff syndrome. Patient website. Available at: https://patient.info/doctor/wernicke-korsakoff-syndrome. Accessed March 2, 2021.

Wernicke-Korsakoff syndrome. Radiopaedia website. Available at: https://radiopaedia.org/articles/wernicke-korsakoff-syndrome. Accessed March 2, 2021.

Wernicke-Korsakoff syndrome information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Wernicke-Korsakoff-Syndrome-Information-Page. Accessed March 2, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 01/2021
  • Update Date: 03/02/2021