Wernicke’s encephalopathy occurs as a result of thiamine (vitamin B1) deficiency. It was originally described by German neurologist Karl Wernicke in 1881 who observed the three cardinal features of Wernicke’s in two men with chronic alcoholism and a young woman who had ingested sulfuric acid and suffered prolonged episodes of vomiting. The three cardinal features are ophthalmoplegia, ataxia and confusion. It is largely undiagnosed, due to its vague presentation. Patients often present with confusion or altered mental status; a common presentation in those who might be intoxicated. The classic triad of symptoms described in textbooks is rarely seen. If not promptly or adequately treated Korsakoff’s syndrome, a late complication can develop, resulting in memory loss, confabulation and, ultimately, death.
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