Wernicke encephalopathy

All content is checked by medical journalists.

Wernicke encephalopathy is a brain disease that usually affects people with malnutrition. Often these are alcoholics or people with disturbed eating habits. Possible symptoms of Wernicke encephalopathy include restlessness, disorientation, and coordination, memory and visual disorders. Read everything you need to know about Wernicke encephalopathy here.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. E51F10

Wernicke encephalopathy: description

Wernicke encephalopathy is a brain disease named after the physician Carl Wernicke. The medical term "encephalopathy" encompasses diseases or damage that affect the whole brain. Wernicke encephalopathy usually occurs as a result of persistent undernourishment or malnutrition, often in alcoholic people or people with disturbed eating habits.

As a result of Wernicke's encephalopathy, various symptoms that affect the nervous system (neurological symptoms) can occur.Together with Wernicke encephalopathy, the so-called Korsakoff syndrome can also occur - the common occurrence of several typical symptoms (for example short- or long-term memory disorders, fabulating). Doctors often speak of a Wernicke-Korsakoff syndrome.

Wernicke encephalopathy should be treated as quickly as possible, as this has a positive effect on the further course of the disease. It is therefore also important to consult a doctor immediately if those affected or their relatives notice neurological abnormalities such as impaired vision or coordination. This is especially true if there are risk factors for Wernicke encephalopathy such as alcohol problems or eating disorders.

Wernicke encephalopathy: symptoms

In Wernicke encephalopathy, the function of the entire brain can be impaired. Accordingly, it can cause severe symptoms. Affected people often have difficulty coordinating their movements as usual. This manifests itself, for example, in the fact that they have difficulty walking and / or standing. In addition, there are often visual disturbances that result from problems with eye coordination. In addition, people with Wernicke encephalopathy often have a faster heartbeat, a lowered body temperature and an excessive need for sleep.

Furthermore, Wernicke encephalopathy is usually also noticeable in the behavior and psychological well-being of those affected. Doctors and relatives describe patients with Wernicke encephalopathy as extremely restless, mentally confused and disoriented. Often the patients can no longer think clearly, can no longer absorb and / or retain information as usual. In addition, so-called tremor can occur, which is expressed by tremors, for example of the hands.

In addition to Wernicke encephalopathy, doctors often diagnose what is known as Korsakov syndrome (collectively called Wernicke-Korsakov syndrome). In addition to the symptoms mentioned, there are typically problems in recognizing one's own whereabouts: a patient in the hospital then, for example, states that he is sitting in the waiting room of a lawyer and waiting for the lawyer (the doctor). People with Wernicke-Korsakoff syndrome often try to cover up or cover up memory lapses with invented facts. In addition, the memory performance is significantly worsened in Korsakoff syndrome.

Wernicke encephalopathy: causes and risk factors

The cause of Wernicke encephalopathy is an inadequate supply of vitamin B1 (thiamine) to the brain. There may also be hereditary factors that increase the risk of developing Wernicke encephalopathy with a vitamin B1 deficiency. However, this has not yet been conclusively clarified.

The permanent deficiency in vitamin B1 damages the nerve cells of the brain, which increasingly affects them and ultimately dies. This can mean that the brain can no longer perform certain tasks, such as movement or eye coordination, as usual.

There can be various reasons for an insufficient supply of vitamin B1. Often, malnutrition or malnutrition, as often occurs in alcoholic people or people with eating disorders, leads to a vitamin B1 deficiency. People who are heavily dependent on alcohol sometimes cover their entire energy needs with alcoholic beverages, which inevitably leads to deficiency symptoms - not just of vitamin B1. People with eating disorders who adhere to a very strict diet for long periods of time, including completely abstaining from food, and / or who vomit the food they have consumed again, often take in too little or no vitamin B1 for precisely these reasons.

However, there are other causes of Wernicke encephalopathy, which are relatively rare in comparison: A critical vitamin B1 deficiency can occasionally occur in people who are fed via infusions. In addition, diseases of the kidneys, malignant changes in the gastrointestinal tract and tuberculosis infections, among other things, can mean that the body can no longer absorb sufficient thiamine. This can also lead to Wernicke encephalopathy.

Wernicke encephalopathy: examinations and diagnosis

If a patient presents to the doctor with the classic symptoms of Wernicke encephalopathy, the patient's descriptions and specific inquiries may already lead to the suspicion of Wernicke encephalopathy. Since time is an important factor in their treatment, it should be initiated if there is an existing suspicion and before the diagnosis is one hundred percent established.

In order to reliably diagnose Wernicke encephalopathy, the doctor will arrange a comprehensive blood test to determine the vitamin B1 level and other relevant blood values. In addition, a measurement of the brain waves (electroencephalography, EEG), an examination of the spinal cord fluid (CSF puncture) and an magnetic resonance tomography (magnetic resonance tomography) of the head are carried out in order to confirm the diagnosis and to rule out other diseases as the cause of the symptoms. A later blood test after the start of treatment with vitamin B1 can definitively confirm the diagnosis of Wernicke 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 is actually present.

Wernicke encephalopathy: treatment

If the doctor suspects Wernicke encephalopathy, he immediately begins therapy. This consists of a single, high-dose injection of vitamin B1 followed by further daily vitamin B1 injections, which are slightly lower in dose. The injections usually end as soon as the patient's health has stabilized again.

If there is a risk that a patient will develop a severe vitamin B deficiency again in the future, the doctor may recommend taking vitamin B1 supplements as a preventive measure. This risk is particularly acute if the underlying cause of Wernicke encephalopathy persists. It is therefore important to treat existing risk factors such as alcohol addiction or eating disorders. If the reason for Wernicke encephalopathy is unclear, other possible causes such as malignant changes in the gastrointestinal tract, kidney disease, or infection should be ruled out.

Wernicke encephalopathy: prevention

Wernicke encephalopathy can be prevented by treating known risk factors. These include, above all, alcoholism and eating disorders. People at risk should clarify with their doctor whether the preventive intake of vitamin B1 supplements is recommended for them. Known alcoholic and / or malnourished people who are fed with infusion solutions in the hospital should also receive vitamin B1 with their infusions in order to avoid an infusion-related deficiency. A diet-related vitamin B1 deficiency that leads to Wernicke encephalopathy cannot arise in a normal lifestyle.

Wernicke encephalopathy: disease course and prognosis

In Wernicke encephalopathy, how quickly it is treated is crucial. With timely treatment, many symptoms such as visual disturbances and clouding of consciousness usually go away again within a short time. Movement disorders usually take several weeks to go away. In around four out of ten cases, permanent motor impairments remain, three quarters of the patients retain psychological impairments.

For more than ten percent of those affected, Wernicke encephalopathy is fatal despite timely therapy. The cause of this are often cardiovascular problems or infections that were triggered or promoted by the disease. If Wernicke encephalopathy is left untreated, sick people fall into a coma within one to two weeks and die.

Tags:  drugs symptoms pregnancy birth