Wernickes encephalopathy

Question 1

define Wernickes encephalopathy?

Answer 1

the presence of neurological symptoms caused by biochemical lesions of the central nervous system following exhaustion of vitamin B (thiamine B1)

Question 2

main cause of wernickes encephalopathy?

Answer 2

CHRONIC ALCOHOL CONSUMPTION

Question 3

why does alcoholism cause wernickes?

Answer 3

o Inadequate nutritional thiamine intake
o Decreased thiamine absorption
o Impaired thiamine utilisation by cells

Question 4

epidemiology of wernickes?

Answer 4

• Prevalence rates are higher in areas of socio-economic deprivation
• Higher prevalence in 50-60 year olds

Question 5

presenting symptoms of wernickes?

Answer 5

• Vision changes
• unsteady gait
• Loss of memory
• Inability to form new memories
• Hallucinations

Question 6

what are the typical signs of wernickes?

Answer 6

• Wernicke’s is classically defined by a triad of signs:
o Confusion
o Ophthalmoplegia
o Ataxia

Question 7

what might happen to a patient if the wernickes is not treated?

Answer 7

Korsakoff's Psychosis 
leading to the additional symptoms of: 
o	Amnesia 
o	Confabulation 
o	It is NOT REVERSIBLE

Question 8

how is wernickes diagnosed?

Answer 8

history and examination

• Possible useful tests:
o FBC (high MCV is a common feature amongst alcoholics)
o U&Es (exclude metabolic imbalances as a cause of confusion)
o LFTs
o Glucose
o ABG (hypercapnia and hypoxia can cause confusion)
o Serum thiamine
• CT head scan may be useful