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Emergency: requires immediate attention
Wernicke encephalopathy
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Emergency: requires immediate attention

Wernicke encephalopathy

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Contributors: Jamie Adams MD, Andrea Wasilewski MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

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Synopsis

Wernicke encephalopathy (Common Signs) : Altered mental state, Ataxia, Gaze paralysis, Nystagmus, Malnutrition, Abnormal gait
Common Signs
Wernicke encephalopathy (WE) is an acute neurological disorder resulting from thiamine (vitamin B1) deficiency. It presents with mental confusion (profound disorientation, indifference, and inattention), ophthalmoplegia (horizontal nystagmus or vertical nystagmus with upward gaze, lateral rectus palsy, disconjugate gaze), and ataxia (slow, unsteady, wide-based gait with short-spaced steps).

It is most commonly associated with alcohol use disorder but can result from any condition that leads to thiamine deficiency, including conditions preventing adequate food intake (eg, hyperemesis gravidarum). In alcohol use disorder, it stems from inadequate dietary supply, reduced absorption, decreased hepatic storage, and impaired utilization.

Acute WE is a biochemical rather than a structural lesion. Prompt treatment can produce prompt recovery.

Chronic thiamine deficiency may lead to Korsakoff syndrome (KS; see alcohol-induced persisting amnestic disorder).

Codes

ICD10CM:
E51.2 – Wernicke's encephalopathy

SNOMEDCT:
21007002 – Wernicke's disease

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated:04/04/2021
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Emergency: requires immediate attention
Wernicke encephalopathy
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A medical illustration showing key findings of Wernicke encephalopathy (Common Signs) : Altered mental state, Ataxia, Gaze paralysis, Nystagmus, Malnutrition, Abnormal gait

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