Wernicke Encephalopathy

Wernicke encephalopathy is acute thiamine deficiency affecting the brain, classically in chronic alcoholism but also in malnutrition, prolonged vomiting, bariatric surgery. The classic triad: ophthalmoplegia (nystagmus, lateral rectus palsy), ataxia, and confusion; often the triad is incomplete. Untreated or under-treated, it progresses to Korsakoff syndrome (persistent anterograde/retrograde amnesia). Treatment: immediate parenteral thiamine (must be given before glucose to avoid precipitating acute deterioration).

Common Symptoms

Ophthalmoplegia/nystagmus; gait ataxia; confusion; memory disturbance; hypothermia/hypotension; alcoholism/malnutrition context

Causes and Pathogenesis

Thiamine deficiency impairs cerebral energy metabolism, causing lesions in mammillary bodies, thalamus, periaqueductal gray; hemorrhage/necrosis.

Treatment

Immediate IV thiamine (before glucose); nutritional rehabilitation; supportive care; treat alcoholism

Preventive Measures

Thiamine supplementation in alcoholism/malnutrition; give thiamine before glucose in at-risk patients.

Department to Visit

It is recommended to visit the Neurology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.