Wernicke encephalopathy

Wernicke encephalopathy is an acute brain disorder caused by deficiency of vitamin B1 (thiamine), and it often occurs together with Korsakoff syndrome, a disorder of memory. It is usually linked to chronic alcohol misuse, although other causes exist, and it may go undiagnosed because its frequency is not well established. Poor absorption of thiamine is central: causes include severe alcohol use disorder, malabsorption, chronic illness, weight-loss surgery, HIV, chemotherapy, severe vomiting in pregnancy, long dialysis and intravenous nutrition lacking thiamine. Typical features are confusion, poor muscle coordination, abnormal eye movements, double vision, drooping eyelids, low blood pressure and low body temperature, and it can progress to coma and death. Diagnosis rests on neurological examination and nutrition tests, including blood thiamine levels; brain MRI is usually unnecessary because treatment cannot wait. Thiamine is usually injected as soon as possible, with hospital care when needed, and stopping alcohol prevents further brain damage.

Seek emergency care for a first seizure, a seizure lasting more than five minutes, a sudden severe headache, new weakness or confusion, or thoughts of harming yourself. See a doctor for headaches that are more frequent or changing, memory problems that affect daily life, or low mood lasting more than two weeks. Call the local emergency number for any symptom that is sudden and severe. This page is a reference for healthcare professionals and does not replace an assessment.