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Definition

Wernicke encephalopathy is a brain disorder. It can be associated with a variety of symptoms such as confusion, lack of muscle coordination, and eye movement difficulties.

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Causes

Wernicke encephalopathy is caused by thiamine (vitamin B1) deficiency. The deficiency may be caused by poor nutrition, problems absorbing vitamins, or both.

Vitamin B deficiency is common in those with alcohol use disorder (AUD). Excessive intake of alcohol is associated with poor diets and damage to the intestines that make it difficult to absorb vitamins. However, not everyone with AUD develops Wernicke encephalopathy. A combination of genes and diet may play a role.

Risk Factors

Factors that may increase your chances of Wernicke encephalopathy:

  • AUD
  • Poor nutrition or fasting
  • A diet rich in carbohydrates
  • Cancer and chemotherapy treatments
  • Gastrointestinal disorders and surgical procedures
  • Severe vomiting
  • Systemic diseases, such as AIDS , renal diseases, infections, and thyroid disease
  • Dialysis
  • Eating disorders
  • Certain medications

Symptoms

Symptoms may include:

  • Mental status changes, including confusion, poor concentration, lack of emotion, and memory loss
  • Vision problems
  • Poor coordination
  • Difficulty walking and sitting
  • Nausea and vomiting

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

A blood tests can measure the level of thiamine in your blood.

Treatment

Talk with your doctor about the best treatment plan for you. Options include:

  • Thiamine supplements—To treat the thiamine deficiency that is causing your Wernicke encephalopathy.
  • Dietary changes—You may be referred to a dietitian to help with meal planning, especially if your diet is high in carbohydrates.

If Wernicke encephalopathy is associated with AUD or an eating disorder, you may be referred to a rehabilitation facility.

Prevention

To help reduce your chances of Wernicke encephalopathy:

  • Ensure that you are getting enough thiamine in your diet.
    • Daily goals are 1.1 milligrams (mg) a day for women and 1.2 mg a day for men
    • Include foods rich in thiamine such as lentils, peas, fortified breakfast cereal, pecans, spinach, oranges, milk, and eggs
  • Limit your alcohol intake to a moderate level.
    • Moderate is 2 or fewer drinks per day for men and 1 or fewer drinks per day for women
    • If you have a drinking problem, talk to your doctor right away about treatment options.

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 December 21, 2017.

Kaineg B, Hudgins M. Wernicke’s encephalopathy. N Engl J Med. 2005;352(19):e18.

Lukas RV, Piantino J, Ksiazek S, et al. MRI changes in a head and neck cancer patient with Wernicke’s Encephalopathy and visual loss. Neuro-Ophthalmology. 2011;35(5-6):272-275.

Wernicke encephalopathy. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T115007/Wernicke-encephalopathy  . Updated June 15, 2017. Accessed December 21, 2017.

Wernicke-Korsakoff syndrome. Patient website. Available at: https://patient.info/doctor/wernicke-korsakoff-syndrome. Updated September 19, 2014. Accessed December 21, 2017.

Wernicke-Korsakoff syndrome. Radiopaedia website. Available at: https://radiopaedia.org/articles/wernicke-korsakoff-syndrome. Accessed December 21, 2017

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 December 21, 2017.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 11/2018
  • Update Date: 11/16/2015