North Carolina Neurological Foundation

Dedicated to Empowering Lives For Those Affected by Neurological Conditions.

Wernicke Encephalopathy

Wernicke encephalopathy is an acute neuropsychiatric disorder caused by thiamine (vitamin B1) deficiency. Clinical features include ophthalmoplegia, ataxia, and confusion (classic triad). Etiology includes chronic alcoholism, malnutrition, and gastrointestinal surgery. Pathophysiology involves neuronal energy failure and selective vulnerability of thalamic, mammillary, and cerebellar structures. Diagnosis is clinical, supported by MRI. Management includes prompt parenteral thiamine administration; prognosis improves with early treatment, but delayed therapy may result in Korsakoff syndrome.