Wernicke Encephalopathy

Definition

Wernicke encephalopathy is a brain disease. It can lead to confusion, poor muscle control, and other problems. If left untreated, it can get worse and even be fatal.

The Brain.

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Causes

Wernicke encephalopathy is caused by low thiamine (vitamin B1) levels. This may be due to a poor diet, problems absorbing vitamins, or both.

Risk Factors

Wernicke encephalopathy is most common in people with alcohol use disorder. Other things that raise the risk are:

• Cancer and cancer treatments
• Severe vomiting
• Poor diet
• Eating disorders
• Digestive problems and surgeries, such as gastric bypass
• Other diseases, such as AIDS, kidney diseases, infections, and thyroid disease
• Dialysis

Symptoms

A person with Wernicke encephalopathy may have:

• Mental changes, such as:
  • Confusion
  • Problems staying focused
  • Memory loss
• Vision problems
• Problems walking and sitting

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done.

A blood test can check thiamine levels.

Treatment

The goal of treatment is to bring thiamine levels back to normal fast. Wernicke encephalopathy needs to be treated right away. Most symptoms will fade with treatment. Memory problems may continue.

Treatment involves:

• Giving thiamine—through IV or injections
• Keeping thiamine levels normal with:
  • Thiamine supplements
  • A diet rich in thiamine
• Treating alcohol use disorder or eating disorders

Prevention

To reduce the risk of Wernicke encephalopathy:

• Eat foods high in thiamine, such as:
  • Lentils and peas
  • Cereal—with added vitamins
  • Pecans
  • Spinach
  • Oranges
  • Milk and eggs
• Limit alcohol or treat alcohol use disorder.