Wernicke encephalopathy: Difference between revisions
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'''Wernicke encephalopathy''' is a [[neurological disorder]] characterized by a triad of symptoms: [[mental confusion]], [[oculomotor dysfunction]], and [[gait ataxia]]. It is caused by a deficiency in [[thiamine]] (vitamin B1), often associated with [[alcoholism]] and [[malnutrition]]. | {{SI}} | ||
{{Infobox medical condition | |||
| name = Wernicke encephalopathy | |||
| image = [[File:Hypothalamus_image.png|250px]] | |||
| caption = The [[hypothalamus]], one of the areas affected in Wernicke encephalopathy | |||
| field = [[Neurology]] | |||
| symptoms = [[Confusion]], [[ataxia]], [[ophthalmoplegia]] | |||
| complications = [[Korsakoff syndrome]] | |||
| onset = Acute | |||
| duration = Variable | |||
| causes = [[Thiamine deficiency]] | |||
| risks = [[Alcohol use disorder]], [[malnutrition]], [[eating disorders]], [[hyperemesis gravidarum]] | |||
| diagnosis = Clinical, supported by [[MRI]] | |||
| differential = [[Hepatic encephalopathy]], [[hypoglycemia]], [[stroke]] | |||
| prevention = [[Thiamine]] supplementation | |||
| treatment = Intravenous [[thiamine]] | |||
| prognosis = Variable, can lead to permanent [[neurological damage]] if untreated | |||
| frequency = Unknown, more common in populations with high rates of [[alcoholism]] | |||
}} | |||
'''Wernicke encephalopathy''' is a [[neurological disorder]] characterized by a triad of symptoms: [[mental confusion]], [[oculomotor dysfunction]], and [[gait ataxia]]. It is caused by a deficiency in [[thiamine]] (vitamin B1), often associated with [[alcoholism]] and [[malnutrition]]. | |||
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==Etiology== | ==Etiology== | ||
The primary cause of Wernicke encephalopathy is thiamine deficiency. Thiamine is an essential nutrient that plays a key role in [[carbohydrate metabolism]] and [[neuronal function]]. The most common cause of thiamine deficiency is chronic alcoholism, but it can also occur in individuals with malnutrition due to conditions such as [[anorexia nervosa]], [[gastric bypass surgery]], and [[AIDS]]. | |||
The primary cause of Wernicke encephalopathy is thiamine deficiency. Thiamine is an essential nutrient that plays a key role in [[carbohydrate metabolism]] and [[neuronal function]]. The most common cause of thiamine deficiency is chronic alcoholism, but it can also occur in individuals with malnutrition due to conditions such as [[anorexia nervosa]], [[gastric bypass surgery]], and [[AIDS]]. | [[File:MRI FLAIR sequence Wernicke Encephalopathy.jpg|left|thumb|MRI FLAIR sequence Wernicke Encephalopathy]] | ||
[[File:MRI FLAIR sequence Wernicke Encephalopathy.jpg|thumb|MRI FLAIR sequence Wernicke Encephalopathy]] | |||
==Pathophysiology== | ==Pathophysiology== | ||
Thiamine deficiency disrupts the [[Krebs cycle]], leading to a decrease in the production of [[adenosine triphosphate]] (ATP). This results in an energy crisis in the brain, leading to neuronal death and the symptoms of Wernicke encephalopathy. The areas of the brain most affected are the [[mammillary bodies]], [[medial thalamus]], [[periaqueductal gray]], and [[superior cerebellar vermis]]. | Thiamine deficiency disrupts the [[Krebs cycle]], leading to a decrease in the production of [[adenosine triphosphate]] (ATP). This results in an energy crisis in the brain, leading to neuronal death and the symptoms of Wernicke encephalopathy. The areas of the brain most affected are the [[mammillary bodies]], [[medial thalamus]], [[periaqueductal gray]], and [[superior cerebellar vermis]]. | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
The classic triad of symptoms in Wernicke encephalopathy is mental confusion, oculomotor dysfunction, and gait ataxia. However, not all patients present with all three symptoms. Other symptoms may include [[nystagmus]], [[hypothermia]], and [[hypotension]]. If left untreated, Wernicke encephalopathy can progress to [[Korsakoff syndrome]], a chronic and debilitating condition characterized by [[memory loss]] and [[confabulation]]. | The classic triad of symptoms in Wernicke encephalopathy is mental confusion, oculomotor dysfunction, and gait ataxia. However, not all patients present with all three symptoms. Other symptoms may include [[nystagmus]], [[hypothermia]], and [[hypotension]]. If left untreated, Wernicke encephalopathy can progress to [[Korsakoff syndrome]], a chronic and debilitating condition characterized by [[memory loss]] and [[confabulation]]. | ||
==Diagnosis== | ==Diagnosis== | ||
Diagnosis of Wernicke encephalopathy is primarily clinical, based on the presence of the symptom triad and a history of risk factors such as alcoholism or malnutrition. [[Magnetic resonance imaging]] (MRI) can show characteristic changes in the affected areas of the brain, but these are not always present. Thiamine levels can be measured, but these are not always reliable as they can be normal in up to 50% of patients with the condition. | Diagnosis of Wernicke encephalopathy is primarily clinical, based on the presence of the symptom triad and a history of risk factors such as alcoholism or malnutrition. [[Magnetic resonance imaging]] (MRI) can show characteristic changes in the affected areas of the brain, but these are not always present. Thiamine levels can be measured, but these are not always reliable as they can be normal in up to 50% of patients with the condition. | ||
==Treatment== | ==Treatment== | ||
Treatment for Wernicke encephalopathy involves immediate administration of thiamine. This is typically given intravenously in a hospital setting. In addition to thiamine replacement, treatment of the underlying cause of the deficiency, such as alcoholism or malnutrition, is necessary to prevent recurrence of the condition. | Treatment for Wernicke encephalopathy involves immediate administration of thiamine. This is typically given intravenously in a hospital setting. In addition to thiamine replacement, treatment of the underlying cause of the deficiency, such as alcoholism or malnutrition, is necessary to prevent recurrence of the condition. | ||
==See Also== | ==See Also== | ||
* [[Korsakoff syndrome]] | * [[Korsakoff syndrome]] | ||
| Line 39: | Line 45: | ||
* [[Alcoholism]] | * [[Alcoholism]] | ||
* [[Malnutrition]] | * [[Malnutrition]] | ||
[[Category:Neurological disorders]] | [[Category:Neurological disorders]] | ||
[[Category:Vitamin deficiencies]] | [[Category:Vitamin deficiencies]] | ||
Latest revision as of 19:25, 8 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Wernicke encephalopathy | |
|---|---|
| |
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Confusion, ataxia, ophthalmoplegia |
| Complications | Korsakoff syndrome |
| Onset | Acute |
| Duration | Variable |
| Types | N/A |
| Causes | Thiamine deficiency |
| Risks | Alcohol use disorder, malnutrition, eating disorders, hyperemesis gravidarum |
| Diagnosis | Clinical, supported by MRI |
| Differential diagnosis | Hepatic encephalopathy, hypoglycemia, stroke |
| Prevention | Thiamine supplementation |
| Treatment | Intravenous thiamine |
| Medication | N/A |
| Prognosis | Variable, can lead to permanent neurological damage if untreated |
| Frequency | Unknown, more common in populations with high rates of alcoholism |
| Deaths | N/A |
Wernicke encephalopathy is a neurological disorder characterized by a triad of symptoms: mental confusion, oculomotor dysfunction, and gait ataxia. It is caused by a deficiency in thiamine (vitamin B1), often associated with alcoholism and malnutrition.
Etiology[edit]
The primary cause of Wernicke encephalopathy is thiamine deficiency. Thiamine is an essential nutrient that plays a key role in carbohydrate metabolism and neuronal function. The most common cause of thiamine deficiency is chronic alcoholism, but it can also occur in individuals with malnutrition due to conditions such as anorexia nervosa, gastric bypass surgery, and AIDS.
Pathophysiology[edit]
Thiamine deficiency disrupts the Krebs cycle, leading to a decrease in the production of adenosine triphosphate (ATP). This results in an energy crisis in the brain, leading to neuronal death and the symptoms of Wernicke encephalopathy. The areas of the brain most affected are the mammillary bodies, medial thalamus, periaqueductal gray, and superior cerebellar vermis.
Clinical Presentation[edit]
The classic triad of symptoms in Wernicke encephalopathy is mental confusion, oculomotor dysfunction, and gait ataxia. However, not all patients present with all three symptoms. Other symptoms may include nystagmus, hypothermia, and hypotension. If left untreated, Wernicke encephalopathy can progress to Korsakoff syndrome, a chronic and debilitating condition characterized by memory loss and confabulation.
Diagnosis[edit]
Diagnosis of Wernicke encephalopathy is primarily clinical, based on the presence of the symptom triad and a history of risk factors such as alcoholism or malnutrition. Magnetic resonance imaging (MRI) can show characteristic changes in the affected areas of the brain, but these are not always present. Thiamine levels can be measured, but these are not always reliable as they can be normal in up to 50% of patients with the condition.
Treatment[edit]
Treatment for Wernicke encephalopathy involves immediate administration of thiamine. This is typically given intravenously in a hospital setting. In addition to thiamine replacement, treatment of the underlying cause of the deficiency, such as alcoholism or malnutrition, is necessary to prevent recurrence of the condition.
See Also[edit]
