Wernicke’s encephalopathy

Wernicke’s encephalopathy: description

Wernicke’s encephalopathy is a brain disease named after the physician Carl Wernicke. The medical term “encephalopathy” refers to diseases or injuries that affect the entire brain. Wernicke’s encephalopathy usually occurs as a result of persistent malnutrition or malnutrition, often in alcoholics or people with disturbed eating habits.

As a result of Wernicke’s encephalopathy, various signs of the disease can occur that affect the nervous system (neurological symptoms). Along with Wernicke’s encephalopathy, the so-called Korsakoff syndrome can also occur – the common occurrence of several typical symptoms (for example, short or long-term memory disorders, fabulation). Often doctors also speak of a Wernicke-Korsakoff syndrome.

Wernicke’s encephalopathy should be treated as quickly as possible, as it has a positive effect on the further course of the disease. Therefore, it is also important to see a doctor immediately if sufferers themselves or their relatives notice neurological abnormalities such as vision or coordination disorders. This is especially true when there are risk factors for Wernicke’s encephalopathy such as alcohol problems or eating disorders.

Wernicke’s encephalopathy: symptoms

In Wernicke’s encephalopathy, the entire brain may be impaired in function. Accordingly, it can cause severe symptoms. Thus, sufferers often have difficulty coordinating their movements as usual. This manifests itself, for example, in having difficulty walking and / or standing. In addition, there are often visual disturbances that result from problems with eye coordination. In addition, people with Wernicke’s encephalopathy often have a faster heart rate, a lowered body temperature and an oversized need for sleep.

Furthermore, Wernicke’s encephalopathy usually manifests itself in the behavior and mental health of those affected. Physicians and relatives describe patients with Wernicke’s encephalopathy as extremely restless, mentally confused and disoriented. Often, patients can no longer think clearly, take more information as usual and / or keep it. In addition, so-called tremor can occur, which manifests itself by trembling, for example, the hands.

In addition to Wernicke’s encephalopathy, doctors often diagnose a so-called Korsakoff syndrome (commonly called Wernicke-Korsakoff syndrome). In addition to the above symptoms, there are then typically problems to recognize one’s own whereabouts: a patient in the hospital is then, for example, on demand to sit in the waiting room of a lawyer and to wait for the lawyer (the doctor). Memory lapses try to cover up people with a Wernicke-Korsakoff syndrome often with invented facts or to cover up. In addition, the memory performance in a Korsakoff syndrome is again significantly worsened.

Wernicke’s encephalopathy: causes and risk factors

The cause of Wernicke’s encephalopathy is poor supply of the brain with vitamin B1 (thiamine). There may also be hereditary factors that increase the risk of developing Wernicke encephalopathy if there is a vitamin B1 deficiency. However, this has not yet been finally clarified.

The permanent deficiency of vitamin B1 damages the nerve cells of the brain, causing them to become increasingly impaired and ultimately die off. This can lead to the brain not being able to perform certain tasks, such as movement or eye coordination, as usual.

There can be various reasons for a shortage of vitamin B1. Often, deficiency or malnutrition, as is often the case in alcoholics or people with eating disorders, leads to a vitamin B1 deficiency. Strongly alcoholic people sometimes cover their entire energy needs with alcoholic beverages, which inevitably leads to deficiency symptoms – not just vitamin B1. People with eating disorders who follow a very strict diet for a long period of time to the point of completely abstaining from eating and / or vomiting the ingested food often also take too little or no vitamin B1 for these same reasons.

However, there are other, relatively rare causes of Wernicke’s encephalopathy: For example, a critical vitamin B1 deficiency can occasionally occur in people who are fed on infusions. In addition, among other diseases of the kidney, malignant changes in the gastrointestinal tract and tuberculosis infections cause the body can no longer absorb enough thiamine. As a result, Wernicke encephalopathy can also develop.

Wernicke’s encephalopathy: examinations and diagnosis

If a patient presents with the classic symptoms of Wernicke’s encephalopathy to the doctor, the patient may already be suspected of having Wernicke’s encephalopathy due to the patient’s descriptions and specific inquiries. Since time is an important factor in their treatment, it should be initiated in the event of an existing suspicion and prior to a complete diagnosis.

To safely diagnose Wernicke’s encephalopathy, the doctor initiates a comprehensive blood test to determine vitamin B1 levels and other relevant blood levels. In addition, cerebral flow (electroencephalography, EEG), cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) of the head are used to confirm the diagnosis and rule out other conditions as the cause of the symptoms. Subsequent blood testing after initiation of treatment with vitamin B1 can definitively confirm the diagnosis of Wernicke’s encephalopathy: if the values ​​for certain blood markers that indicate a vitamin B1 deficiency deviate significantly from the values ​​of the first blood test, this is the ” Proof “that Wernicke encephalopathy actually exists.

Wernicke’s encephalopathy: treatment

If the doctor has the suspicion of a Wernicke encephalopathy, he begins immediately with the therapy. This consists of a single high-dose injection of vitamin B1 and then further daily vitamin B1 injections, which are slightly lower. The injections usually end as soon as the patient has stabilized again.

If there is a risk that a patient may develop a strong vitamin B deficiency in the future, the doctor can recommend taking vitamin B1 supplements as a preventive measure. This risk mainly exists when the underlying cause of Wernicke’s encephalopathy persists. Therefore, it is important to treat existing risk factors such as alcohol dependence or eating disorders. If the cause of Wernicke’s encephalopathy is unclear, other possible causes such as malignant changes in the gastrointestinal tract, kidney disease or infection should be ruled out.

Wernicke’s Encephalopathy: Prevention

Wernicke encephalopathy can be prevented by treating known risk factors. These include, above all, alcoholism and eating disorders. Vulnerable people should check with their doctor if taking vitamin B1 supplements is recommended for them. Known alcoholic and / or malnourished people who are fed on infusion solutions in the hospital should also receive vitamin B1 with their infusions to avoid an infusion-related deficiency. In normal life, diet-related vitamin B1 deficiency can not develop, leading to a Wernicke’s encephalopathy leads.

Wernicke’s encephalopathy: disease course and prognosis

In Wernicke’s encephalopathy, how quickly treatment is critical. In case of timely treatment, many symptoms such as visual disturbances and clouding of consciousness usually return within a short time. Movement disorders usually take several weeks to disappear. In about four out of ten cases, motor impairments persist and three quarters of patients retain mental disabilities.

For more than ten percent of those affected, Wernicke’s encephalopathy is fatal, despite timely treatment. The cause of this is often cardiovascular problems or infections that were triggered or promoted by the disease. Will one Wernicke’s encephalopathy If left untreated, a person falls into a coma within one to two weeks and dies.