What is wernicke encephalopathy?
Wernicke encephalopathy is a disease of the brain, which is usually affected by people with a nutritional deficiency. These people are often alcoholics with abnormal eating habits. The possible symptoms of wernicke encephalopathy include restlessness, disorientation as well as coordination, memory and vision problems.
Wernicke encephalopathy is a disease of the brain named after the physician Carl Wernicke. The medical term “encephalopathy” encompasses diseases or lesions affecting the whole brain. Wernicke encephalopathy usually occurs as a result of a persistent malnutrition, often in the case of persons with an alcoholic disorder with abnormal eating habits.
As a result of Wernicke encephalopathy, various signs of disease affecting the nervous system (neurological symptoms) may occur. Together with a Wernicke encephalopathy, the so-called Korsakov syndrome can also ocur.
Wernicke encephalopathy should be treated as quickly as possible, since this will have a positive effect on the further course of the disease. Therefore, it is also important to consult a doctor immediately if the person concerned or his / her relatives notice neurological abnormalities such as vision or coordination disorders. This is particularly true when there are risk factors for Wernicke encephalopathy, such as alcohol problems or eating disorders.
Wernicke encephalopathy symptoms
In a Wernicke encephalopathy, the entire brain can be affected in its function. Accordingly, it can cause severe symptoms. In this way, affected people often have difficulty coordinating their movements as usual. For example, by having difficulty walking and / or standing. In addition, In addition, people with a Wernicke encephalopathy often have a faster heart attack, a lower body temperature and much more sleep requirement.
Furthermore, Wernicke encephalopathy is usually also noticeable in the behaviour and mental health of affected persons. Physicians and relatives describe patients with Wernicke encephalopathy as extremely restless, mentally confused and disoriented.
Often, patients can no longer think clearly, receive and/or retain information as usual. In addition, tremor can occur, which manifests itself by trembling, for example of the hands.
In addition to a Wernicke encephalopathy, physicians often diagnose a so-called Korsakov syndrome (Wernicke-Korsakov syndrome). In addition to the symptoms mentioned, there are typically problems of recognizing one’s own place of residence. Memory gaps try to overplay or cover up people with a Wernicke-Korsakov syndrome often with fictional behavior. Memory performance of a Korsakov syndrome is significantly worse.
Wernicke encephalopathy causes and risk factors
The cause of Wernicke’s encephalopathy is a deficient supply of the brain with vitamin B1 (thiamine). There may also be hereditary factors that increase the risk of developing a Wernicke encephalopathy in the case of vitamin B1 deficiency. However, this has not yet been conclusively clarified.
The permanent deficiency of vitamin B1 damages the nerve cells of the brain, causing them to become increasingly impaired and eventually die. This can lead to the brain not being able to fulfill certain tasks, for example the movement or eye coordination, as usual.
There may be different reasons for taking vitamin B1. Often a deficiency or malnutrition, as is often the case with alcoholics or people with eating disorders, leads to a deficiency in vitamin B1.
Highly alcohol-dependent people partially cover their entire energy supply via alcoholic beverages, which inevitably leads to deficiency symptoms – not just of vitamin B1. People with eating disorders who over a long period of time follow a very strict diet to the point of total food dependency and vomit the ingested food often also do not have enough vitamin B1 or vitamin B1 at all.
There are other rare causes of Wernicke encephalopathy: Critical vitamin B1 deficiency may occasionally occur in people who are fed via infusions. In addition, diseases of the kidneys, malignant changes of the gastrointestinal tract as well as tuberculosis infections can lead to the body not being able to absorb enough thiamine. As a result, Wernicke encephalopathy may also occur.
Wernicke encephalopathy diagnosis
If a patient presents himself with the classical symptoms of Wernicke encephalopathy at the doctor, this may be due to the patient’s portrayal and deliberate questions about the suspicion of Wernicke encephalopathy. Since time is an important factor in their treatment, this should already be initiated in the case of an existing suspicion and before the 100% determination of the diagnosis.
In order to safely diagnose a Wernicke encephalopathy, the doctor initiates a comprehensive blood test to determine the vitamin B1 level and other relevant bleeding values. In addition, a measurement of the cerebral currents (electroencephalography, EEG), an examination of the spinal fluid (cerebrospinal fluid) and a magnetic resonance tomography (MRI) of the head are performed to substantiate diagnosis and to exclude other diseases as a cause of the symptoms.
A subsequent blood test after the onset of treatment with vitamin B1 can finally confirm the diagnosis of Wernicke encephalopathy: If the values for certain blood markers that point to a vitamin B1 deficiency deviate greatly from the values of the first blood test, this is the “proof” that there is actually a Wernicke encephalopathy.
How is wernicke encephalopathy treated?
If the doctor suspects a Wernicke encephalopathy, he immediately begins the therapy. This consists of a single, highly dosed injection of vitamin B1 and subsequent further daily vitamin B1 injections, which are slightly lower doses. The injections usually end as soon as the patient has stabilized again.
If there is a risk that a patient will again develop a strong vitamin B deficiency in the future, the doctor can recommend the use of vitamin B1 preparations. This risk exists above all when the underlying cause of Wernicke encephalopathy persists.
Therefore, it is important to treat existing risk factors such as alcohol dependency or eating disorders. If the reason for the Wernicke encephalopathy is unclear, further possible causes such as malignant changes in the gastrointestinal tract, renal disease or infections should be excluded.
How to prevent wernicke encephalopathy
Wernicke encephalopathy can be prevented by treating known risk factors. These include mainly alcoholism and eating disorders. People at risk should clarify with their doctor whether the preventative taking of vitamin B1 preparations is recommended for them.
Known alcoholic and/or malnourished people who are fed into the hospital via infusion solutions should also receive vitamin B1 with their infusions in order to avoid an infusion-related deficiency.