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Wernicke’s encephalopathy

Wernicke’s encephalopathy is a degenerative disease of the brain in adults. It occurs in the presence of vitamin B1 deficiency. It was first observed in alcoholics, in whom it also occurs most frequently. Other causes may include chronic bowel disease such as Crohn’s disease.

Vitamin B1 deficiency interferes with carbohydrate metabolism in the brain. As a result, water retention (edema) occurs, and later hemorrhage and the formation of small vessels in some parts of the brain (capillaries) – these parts of the brain are subsequently destroyed as a result.

Classically, three main symptoms are found:

  • An “organic psychosyndrome of the brain” with memory loss, psychosis, confusion and confabulations: Affected individuals spin together stories, connections and other things due to malfunctioning of their memory.
  • Gait and stance insecurity
  • Eye movement disorders and eye muscle paralysis, including double vision.
  • At the beginning, sufferers often complain of double vision, speech disorders, gait unsteadiness and tingling of the legs. In addition, there may be reflex disorders, impaired consciousness, apathy and drowsiness with abnormal sleepiness (somnolence). Fine motor skills may also be impaired. Swallowing and sleep disturbances are observed, as are low blood pressure, subnormal body temperature, or excessive sweating.

Treatment is by administration of high doses of thiamine, in emergencies also intravenously. Regular intake of vitamin B1 can prevent the disease. According to recent studies, taking vitamin B1 can reduce cravings for alcohol.

Wernicke-Korsakow syndrome is a combination of Wernicke encephalopathy and Korsakow syndrome.

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