Wernicke's Encephalopathy

Question 1

Commonest cause?

Answer 1

Alcohol dependence, i.e. Thiamine (vit B1 deficiency)

Question 2

Triad of?

Answer 2

Encephalopathy
Oculomotor Dysfunction
Gait Ataxia

Question 3

Encephalopathy symptoms? (3)

Answer 3

Disorientation
Indifference
Inattentiveness

Question 4

Oculomotor dysfunction? (3)

Answer 4

NYSTAGMUS
ophthalmoplegia (paralysis of the muscles within or surrounding the eye)
double vision

Question 5

Other causes of WE? (4)

Answer 5

Malabsorption
Poor intake
Metabolic disorders
Loss vitamins e.g. dialysis

Question 6

Investigations? (8)

Answer 6

FBC, U&E's, glucose, magnesium 
Serum thiamine (low)
Pyruvate (high)
Serum/urine alcohol levels
MRI

Question 7

Rx?

Answer 7

Thiamine/Pabrinex

Question 8

What can WE progress to?

Answer 8

Korsakoff syndrome

Question 9

Key symptoms of Korsakoff?

Answer 9

Severe Retrograde & anterograde amnesia
Confabulation (sometimes present)

Anterograde: loss of the ability to create new memories after the event that caused the amnesia, leading to a partial or complete inability to recall the recent past, while long-term memories from before the event remain intact.