Wernicke's Encephalopathy

Question 1

What is Wernicke’s Encephalopathy?

Answer 1

Wernicke’s encephalopathy is a neurological emergency resulting from thiamine deficiency with varied neurocognitive manifestations, typically involving mental status changes and gait and oculomotor dysfunction.

Question 2

What are the risk factors of wernickes encephalopathy?

Answer 2

> alcohol dependence
> AIDS
> cancer and treatment with chemotherapeutic agents
> malnutrition
> Hx of GI surgery

Question 3

What are the signs and symptoms of wernickes encephalopathy?

Answer 3

> mental slowing, impaired concentration, and apathy
> frank confusion
> ocular motor findings
> Mild irritability
> Delirium
> Acute psychosis

Question 4

What is the epidemiology of wernickes encephalopathy?

Answer 4

The prevalence of this condition according to unselected autopsy studies varies throughout the world from 0.8% to 2.8%.

Question 5

What investigations would you use for wernicke’s encephalopathy?

Answer 5

> therapeutic trial of parenteral thiamine- clinical response
finger-prick glucose (normal)
FBC (normal)
serum electrolytes (abnormal in late disease)
renal function (abnormal in late disease)
LFTs (elevated)
urinary and serum drug screen (negative)
serum ammonia (normal unless decompensation of ALD)
blood alcohol level
blood thiamine (low) and its metabolites
serum magnesium (May be low)