Wernicke encephalopathy

What is Wernicke encephalopathy?

Wernicke (or Wernicke’s) encephalopathy is a type of brain injury. It is a medical emergency. If not treated quickly, it can lead to permanent brain damage.

What are the symptoms of Wernicke encephalopathy?

Symptoms can vary, but often include problems with your:

• eyes, such as jerky movements, double vision or drooping eyelids
• balance, such as when trying to stand
• movement, such as difficulty walking normally
• mind, such as feeling irritable, disoriented, drowsy, delirious or confused

You may also have:

• a rapid heartbeat
• low blood pressure (known as hypotension)

If you think that you, or someone you know, may have Wernicke encephalopathy, it is very important to get medical help straight away.

What causes Wernicke encephalopathy?

Wernicke encephalopathy is caused by a lack of thiamine (vitamin B1). Thiamine is an essential nutrient for our bodies.

People who drink too much alcohol often do not get enough thiamine. This is because of several factors, including:

• poor diet
• problems with absorbing vitamins from the gut

Your risk of thiamine deficiency can also be increased if you:

• have AIDS
• have malnutrition (poor nutrient intake)
• have ongoing vomiting and diarrhoea
• have cancer
• are having chemotherapy treatment or have had a bone marrow transplant
• have had bariatric surgery
• are on dialysis

When should I see my doctor?

If you have any signs of Wernicke encephalopathy, you need to seek medical help straight away. If you don’t, you run the risk of permanent brain damage.

If you are concerned about whether you are getting enough thiamine in your diet, talk to your doctor or see a dietitian.

How is Wernicke encephalopathy diagnosed?

Your doctor will ask about your symptoms and health in general. They will also examine you.

Your doctor may recommend some tests, such as:

• blood tests
• urine tests
• a CT scan
• an MRI scan

People with Wernicke encephalopathy do not always have the same symptoms, so it can be hard to diagnose. Sometimes, it can be mistaken for other problems that cause confusion, such as alcohol withdrawal or severe liver disease.

How is Wernicke encephalopathy treated?

If you have Wernicke encephalopathy, you will need to be treated with thiamine as quickly as possible. This is usually given by an injection into a vein.

Treatment also involves getting proper nutrition and hydration (enough fluid in to your body).

If you are treated in time, most symptoms of Wernicke encephalopathy can be reversed. Although it can take a while for some symptoms to go away.

Treatment with thiamine supplements may be recommended long-term.

Can Wernicke encephalopathy be prevented?

In Australia, thiamine is added to bread flour. This has helped reduce the number of people with thiamine deficiency and related health problems.

If you have problems with alcohol, seek help before you get a condition like Wernicke encephalopathy. Talk to your doctor or get help from an organisation such as Alcoholics Anonymous.

Taking multivitamins and thiamine supplements is important if you have any condition that puts you at high risk of Wernicke encephalopathy.

Complications of Wernicke encephalopathy

If Wernicke encephalopathy is not diagnosed and treated quickly, it can cause permanent brain injury. This may result in:

• hearing loss
• seizures
• movement problems

Some people with Wernicke encephalopathy develop a condition called Korsakoff syndrome. Symptoms can include:

• severe short-term memory loss
• trouble forming new memories and learning new things