wernicke's encephalopathy

what causes wernicke's encephalopathy?

thiamine (B1) deficiency

which patients is wernicke's encephalopathy most commonly seen in?

alcohol dependent pts

what else can cause wernicke's?

- bariatric surgery

- malnutrition

- hyperemesis gravidarum

what happens pathophysiologically in wernicke's encephalopathy?

petechial haemorrhages in a variety of structures - including mammillary bodies and ventricle walls

what are the clinical features of wernicke's?

- nystagmus

- ophthalmoplegia

- gait ataxia

- encephalopathy

- peripheral sensory neuropathy

what is a way to remember the clinical features of wernicke's?

COAT

confusion

ophthalmoplegia

ataxia

thiamine deficiency

what are the signs of encephalopathy?

- confusion

- diorientation

- indifference

- inattentiveness

what are the investigations for wernicke's?

- MRI

- blood tests

what would be found on blood tests?

decreased red cell transketolase

what is the treatment of wernicke's?

IV pabrinex (thiamine)

if left untreated what could wernicke's develop into?

korsakoff's syndrome