WERNICKE

ENCEPHALOPATHY
By: Nadia Villarruel, Tiana Chan, Daisy Miranda, Vanessa
Barrera, Anderson Nguyen, Anthony Negrete, Tu Bui

What Is It?
According to NINDS,
Wernicke Encephalopathy is a serious neurological disorder due to
thiamine (vitamin B1) deficiency,which mainly occurs to those heavy
alcohol abusers, also to people whose bodies do not absorb food
properly and also those who are acquired with AIDS.
Sometimes it can occur to patients w/ a chronic illness.
It may cause prolonged vomiting and eating disorders.

Stats: The condition affects males slightly more than females

Ages range from 30-70 years of age
Patients with this disease have a mortality rate of 10%-20%
NINDS (2014) , Campellone, J. (2014)

Background
According to Glen Xiong (2014), from Medscape Wernicke was
first discovered :
Wernicke Encephalopathy was first identified in 1881 by Carl
Wernicke, a German neurologist.
In Two males who had problems with alcoholism and a female with
persistent vomiting followed by sulfuric acid ingestion. All three
patients soon developed coma and died. On autopsy, Wernicke
detected punctate hemorrhages affecting the gray matter around
the third and fourth ventricles and aqueduct of Sylvius.

Where is the disease located?

Wernicke Encephalopathy is located in the lower brain it affects
both the Thalamus and Hypothalamus. Campellone, J. (2014)
The Thalamus takes in sensory information and then passes it on to
the cerebral cortex. The cerebral cortex also sends information to
the thalamus, which then sends this information to other systems.
Cherry,K (2014)

The Hypothalamus connects with many regions of the brain and is

responsible for controlling hunger, thirst, emotions, body
temperature regulation, and circadian rhythms. The hypothalamus
also controls the pituitary gland by secreting hormones, which gives
it control over many body functions.Cherry,K (2014)

Imgarcade.com, (2014)
Bio.sunyorange.edu, (N.D.)

How do you get it?

The lack of vitamin B1 causes this disease to occur. Either from:

Alcoholism
Malabsorption- occurs when the body does not absorb the nutrients
from food properly
Chronic Illness
Obesity (Bariatric) Surgery
Beriberi is also a disease which occurs because of a lack of thiamine.
genetic beriberi (very rare) inhibits the affected person from absorbing
thiamine properly from food.
Getting dialysis and taking high doses of diuretics increase the risk
beriberi, which in turn increases the risk of Wernicke Encephalopathy.
infant children who are breastfed are at risk of thiamine deficiency if the
mothers body is lacking thiamine, the same goes with baby formulas

Campellone, J. (2014)

Nerves
According to Table 21.2, Wise, E.
(2004):

Nerves affected by Wernicke Encephalopathy

are the Optic, Oculomotor, Trochlear,
Abducens, Trigeminal and Vagus.
Because of rapid eye movement, the optic
oculomotor, trochlear and abducens nerve are
affected.
Headaches, confusion, and bodily movement
failure will be the result of the trigeminal and
Vagus nerves malfunctioning.

Lynch, (2011)

Symptoms
Confusion and loss of mental activity that can
progress to a coma or death
Loss of muscle coordination (ataxia)
Vision changes, such as abnormal eye movements
(back & forth movements), Eyelids droop
Alcohol withdrawal
Congestive heart failure

So YT, Simon RP. Deficiency diseases of the nervous system. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta
JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 57.
http://www.nlm.nih.gov/medlineplus/ency/article/000771.htm

Tests Performed
According to Salen, P. (2014), the following
diagnosis needs to be performed:

complete Blood Count (CBC)

Serum Glucose Levels

Liver Function Tests & Ammonia Levels
Basic Metabolic Profile (BMP)
Pulse Oximetry/ Arterial Blood Gas (ABG) Measurement
Toxic Drug Screening
Consider Lumbar Puncture (LP)

Treatment
According to Salen, P. from Medscape (2014), Wernicke
Encephalopathy is usually improved with the administration of
thiamine.
Thiamine (Vitamin B1) helps the body convert food (carbohydrates)
into fuel (glucose), which is used to produce energy. Thiamine is
needed for good brain function. Ehrlich, S. (2011)
2 mg of thiamine is prescribed to the average person to reverse the
symptoms Salen, P. (2014)
In some cases, the dosage can go as high as 500 mg of thiamine for
alcoholic patients. Salen, P. (2014)
Although thiamine improves the patient's condition to some degree in
almost all cases,persistent neurologic dysfunction is common.
Salen, P. (2014)

Prognosis and Prevention

Prognosis:
without treatment, Wernicke Encephalopathy can get steadily
worse, eventually becoming life threatening due to the damage
caused
with treatment, some symptoms can be controlled and the disorder
can be stopped, however the the loss of memory skills and damage
to thinking skills can be permanent
Prevention:
moderate drinking with the addition of thiamine supplements along
with receiving the right nutrition reduce the risk
drinking heavily while also taking thiamine supplements does not
remove the risk of getting this disease Campellone, J. (2014)

Wernickes Encephalopathy korsakoff Syndrome

According to Campellone, J. (2014) from MedlinePlus Korsakoff is

AKA as wet brain

A disease which is linked to Wernickes
Encephalopathy
This syndrome may also occur to patients that are not
alcohol abusers
Tends to develop as Wernickes symptoms go away
It also causes brain damage in the thalamus and
hypothalamus
It results in permanent damage in areas of the brain
involved with memory

YouTube,(2007)

1)

QUIZ TIME!!!

What part of the sheep

brain is labeled as A and
B?

3)

4)
A
2)

A person with Wernicke

Encephalopathy has a lack
of what vitamin?

What are two ways you

can receive this
disease?

What is one symptom you

may receive having this
disease?

Bibliography

Bio.sunyorange.edu,. Midbrain. Retrieved 27 October 2014, from

http://bio.sunyorange.edu/updated2/comparative_anatomy/anat.html2/N_MIDBRAIN.htm
Campellone, J. (2014). Wernicke-Korsakoff syndrome. Nlm.nih.gov. Retrieved 27
October 2014, from http://www.nlm.nih.gov/medlineplus/ency/article/000771.htm
Campellone, J. Wernicke-Korsakoff Syndrome, nlm.nih.gov. Retrived 6 October 2014, from
http://www.nlm.nih.gov/medlineplus/ency/article/000771.ht
Cherry, K. (2014). Learn the Basic Structures of Brain Anatomy. About Education.
Retrieved 28 October 2014, from http://psychology.about.com/od/biopsychology/ss/brainstructure_6.htm
Cherry, K. (2014). Learn the Basic Structures of Brain Anatomy. About Education.
Retrieved 28 October 2014, from http://psychology.about.com/od/biopsychology/ss/brainstructure_7.htm
Ehrlich, S. (2011). Vitamine B1 (thiamine) medicalaltmed.com, Retrieved 27 October 2014, from
http://umm.edu/health/medical/altmed/supplement/vitamin-b1-thiamine
Imgarcade.com,. (2014). Gallery For > Brain Hypothalamus And Thalamus. Retrieved 27
October 2014, from http://imgarcade.com/1/brain-hypothalamus-and-thalamus/

Bibliography Continued
Lynch, J. (2011). Brain human normal inferior view with labels. Commons.wikimedia.org.
Retrieved 27 October 2014, from http://commons.wikimedia.org/wiki/File:Brain_human_normal_inferior_view_with_labels_en-2.svg
NINDS,. (2007) . NINDS Wernicke-Korsakoff Syndrome Information Page NIH.gov, Retrieved
18 September 2014, from
http://www.ninds.nih.gov/disorders/wernicke_korsakoff/wernicke-korsakoff.htm

Salen, P. (2014). Wernicke Encephalopathy Treatment medscape.com, Retrieved

27 October 2014, from http://emedicine.medscape.com/article/794583-treatment#showall
Xiong, G. (2014). Wernicke-Korsakoff Syndrome. Emedicine.medscape.com. Retrieved
27 October 2014, from http://emedicine.medscape.com/article/288379-overview
Wise, E. (2004) Cranial Nerves, Functions, Table 21.2, New York, McGraw-HIll Companies, Inc.
YouTube,. (2007). A Case of Confusion (part). Retrieved from
https://www.youtube.com/watch?v=wDcyBXJAZNM
lus/ency/article/000771.ht