Wernicke's encephalopathy

What is Wernicke's Encephalopathy?

Wernicke's encephalopathy is a neurological disorder caused by a deficiency in thiamine (vitamin B₁). This deficiency is in turn usually caused by an inadequate diet, long-term alcohol abuse, or bariatric surgery. It is characterized by a triad of symptoms including confusion, ocular abnormalities (nystagmus, diplopia), and ataxia (loss of muscle coordination). If left untreated, Wernicke's encephalopathy can progress to the more severe and potentially life-threatening Korsakoff syndrome.

Signs and Symptoms

The signs and symptoms of Wernicke's encephalopathy vary but usually include:

  • Confusion
  • Changes in mental status
  • Impaired memory
  • Inability to think abstractly or make proper judgments
  • Poor coordination or balance problems, which can result in falls
  • Inability to pay attention and focus
  • Vision abnormalities, including double vision, poor eye movement, and a decrease in visual field
  • Difficulty speaking or understanding
  • Weakness of muscles in the arms and legs


Wernicke's encephalopathy is usually diagnosed clinically, based on the patient's signs and symptoms. However, imaging of the brain can also be useful in confirming the diagnosis. Typically, the diagnosis can also be made by measuring the levels of thiamine in the patient's blood.


Treatment of Wernicke's encephalopathy is primarily focused on replacing the thiamine that is lacking in the patient's system. This is often done through intravenous injections of thiamine and can lead to a full recovery if the patient is treated early enough. Other treatments may include vitamin supplementation, such as B vitamins, as well as changes in lifestyle, such as reduction of alcohol consumption and improved nutrition.


Wernicke's encephalopathy is a potentially serious condition caused by a deficiency of thiamine in the body. It is characterized by a triad of symptoms including confusion, ocular abnormalities, and ataxia. Early diagnosis and treatment with thiamine replacement therapy is essential, as untreated Wernicke's encephalopathy can progress to the more serious Korsakoff syndrome. Additionally, changes in lifestyle, such as reducing alcohol consumption and improving nutrition, can help prevent the onset of the disorder.