What is Wernicke encephalopathy?

Wernicke (or Wernicke's) encephalopathy is a type of brain injury. It is a medical emergency. If not treated quickly, it can lead to permanent brain damage.

What are the symptoms of Wernicke encephalopathy?

Symptoms can vary, but often include problems with your:

• eyes — jerky movements, double vision or drooping eyelids
• balance — when you're trying to stand
• movement — difficulty walking normally
• mind — feeling irritable, disoriented, sleepy, delirious or confused

You may also have:

• a rapid heartbeat
• hypotension (low blood pressure)

Seek medical help immediately, if you think that you, or someone you know, may have Wernicke encephalopathy.

What causes Wernicke encephalopathy?

Wernicke encephalopathy is caused by a lack of thiamine (vitamin B1). Thiamine is an essential nutrient for your body.

People who drink a lot of alcohol may not get enough thiamine. This is because of many reasons, including:

• poor diet
• problems with absorbing vitamins from the gut

Your chance of thiamine deficiency can also be higher if you:

• have HIV infection or AIDS
• have malnutrition (poor nutrient intake)
• have ongoing vomiting and diarrhoea
• have cancer
• are having chemotherapy or have had a bone marrow transplant
• have had bariatric surgery
• are on dialysis

When should I see my doctor?

If you have any signs of Wernicke encephalopathy, you need to get medical help straight away. If you don't, you are at risk of permanent brain damage.

If you are concerned about whether you are getting enough thiamine in your diet, talk to your doctor or see a dietitian.

How is Wernicke encephalopathy diagnosed?

Your doctor will ask about your symptoms and health in general. They will also examine you.

Your doctor may arrange for you to have some tests, such as:

• blood tests
• urine (wee) tests
• a CT scan
• an MRI scan

People with Wernicke encephalopathy don't always have the same symptoms, so it can be hard to diagnose.

Sometimes, it is mistaken for other problems that cause confusion, such as alcohol withdrawal or severe liver disease.

How is Wernicke encephalopathy treated?

Wernicke encephalopathy is treated with thiamine as quickly as possible. This is usually given by an injection into your vein.

Treatment also involves getting proper nutrition and hydration (enough fluid in to your body).

If you are treated in time, most symptoms of Wernicke encephalopathy can be reversed. Although it can take a while for some of them to go away.

Your doctor may suggest long-term treatment with thiamine supplements.

What are the complications of Wernicke encephalopathy

Without quick treatment, Wernicke encephalopathy can cause permanent brain injury. This may result in:

• hearing loss
• seizures
• movement problems

Some people with Wernicke encephalopathy develop a condition called Korsakoff syndrome. Symptoms of Korsakoff syndrome can include:

• severe short-term memory loss
• trouble forming new memories and learning new things
• making up information to fill in gaps in memory (confabulation)
• hallucinations
• changes in personality
• not understanding or believing you have Korsakoff syndrome

Wernicke-Korsakoff Syndrome is when you have both Wernicke encephalopathy and Korsakoff syndrome.

Can Wernicke encephalopathy be prevented?

In Australia, thiamine is added to bread flour. This has helped lower the number of people with thiamine related health problems.

If you have problems with alcohol, seek help before you get a condition like Wernicke encephalopathy. Talk to your doctor or get help from an organisation such as Alcoholics Anonymous.

Multivitamins and thiamine supplements are important if you have a high chance of getting Wernicke encephalopathy.

Resources and support

If you have problems with alcohol, you can contact Alcoholics Anonymous for information and support — call the Alcoholic Anonymous Helpline on 1300 222 222.

You can also contact the Alcohol and Drug Foundation for resources and support programs —on 1300 858 584.

Dementia Australia offers information and support for people affected by alcohol-related brain injury — call the National Dementia Helpline on 1800 100 500.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.