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Topic: Wernicke’s encephalopathy
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Wernicke’s Encephalopathy – Its Symptoms and Treatment

Wernicke’s encephalopathy, also known as Wernicke encephalopathy (WE), is a neurological condition that comes with neurological symptoms. This life-threatening condition is mainly caused by thiamine deficiency. Patients who are diagnosed with this condition can be at high risk since their peripheral, as well as the central nervous system, are severely affected.

Wernicke’s encephalopathy has often been confused with Wernicke-Korsakoff. But you need to remember that both are different conditions. When Wernicke’s encephalopathy occurs along with alcoholic Korsakoff syndrome, the condition is known as Wernicke–Korsakoff syndrome.

Signs and Symptoms

The patients who are diagnosed with Wernicke’s encephalopathy usually have this triad of symptoms:

  • Ophthalmoplegia: It affects the eye muscle. The eye muscle of the patients who have this symptom becomes weak or gets paralyzed.
  • Confusion: This is a common symptom. However, patients who are in the advanced stage often have some mental changes along with this symptom.
  • Ataxia: It refers to a group of disorders that affect balance, coordination, and speech.

As per researches, only a small share of patients experiences these three symptoms together. People who consume too much alcohol are likely to experience all these three symptoms.

Patients with this condition can also have the following symptoms:

  • Hearing loss
  • Retinal hemorrhage, impaired vision and hearing, pupillary changes, papilledema, and vision loss
  • Apathy, fatigue, drowsiness, and irritability
  • Depression, memory impairment, amnesia, and psychosis
  • Lactic acidosis
  • Polyneuropathy, hypothermia, and hyperhidrosis

Symptoms in the Advanced Stage

Patients with advanced-stage Wernicke’s encephalopathy may have these symptoms:

  • Increased muscle tone
  • Choreic dyskinesias
  • Hyperthermia
  • Coma

No specific symptom has been identified for the patients who are at the early stage of WE.

Risk Factors

People who drink too much alcohol are at high risk of WE. However, recent studies have revealed that the signs and symptoms can also be found among patients who are chronically undernourished. However, the following causes can also increase the risk for WE:

  • AIDS, cancer, febrile infections and Creutzfeldt–Jakob disease
  • Diuretic therapy, renal dialysis, and chemotherapy
  • Chronic diarrhea, liver dysfunction, uremia, and pancreatitis
  • Starvation or frequent fasting, and insufficient parental nutrition

People with normal to high blood thiamine levels can also be at risk.

Treatment

The first step towards treating Wernicke’s encephalopathy is to treat the thiamine deficiency in the patient’s brain. WE is a medical emergency and a reversible condition. This is why, patients with this condition need immediate treatment.

In some cases, WE occurs with chronic Korsakoff syndrome. Therefore, it is also important to look for Korsakoff syndrome symptoms.

Patients who are suspected of WE, require immediate thiamine treatment. Doctors usually continue thiamine treatment until the clinical symptoms have not been treated.

People who have a heavy drinking habit often have poor dietary intakes, and they require high thiamine doses in order to treat WE symptoms. Besides thiamine, the following supplements can be added to improve the patients’ condition – folic acid, cobalamin, zinc, ascorbic acid, etc.

Conclusion

Wernicke’s encephalopathy is a serious medical condition which is why Immediate thiamine treatment is necessary for patients to manage clinical symptoms. Patients who have minimal neurological signs and symptoms, have got the best results from thiamine therapy. However, proper follow-up care is necessary.