Rapid Review: Wernicke Encephalopathy

Reviewed March 2024

Wernicke Encephalopathy

• Associated with chronic alcohol use
• Ataxia and confusion
• PE will show nystagmus, lateral rectus palsy
• Most commonly caused by thiamine (B1) deficiency
• Treatment is thiamine repletion with proper nutrition and hydration
• Korsakoff (irreversible memory loss)

Sample question:

A 53-year-old woman with chronic alcohol use disorder presents with confusion and blurred vision. Her vital signs are within normal limits. Physical examination reveals a wide-based gait, inability to abduct her right eye fully, nystagmus, and difficulty with memory. Her alcohol level is 0.0 mg/dL. Which of the following is most likely to diagnose this patient’s underlying disease process?