Wernicke encephalopathy

Wernicke encephalopathy is an acute brain disorder caused by thiamine deficiency. It can impair mental state, eye movements, and coordination, though the full classic triad is often absent.

Thiamine: Thiamine is a water-soluble vitamin required by enzymes involved in carbohydrate metabolism and cellular energy production. Its deficiency directly causes the metabolic failure underlying Wernicke encephalopathy.
Thiamine replacement: Thiamine replacement is treatment that restores vitamin B1 through oral or parenteral administration. Prompt parenteral thiamine is standard when Wernicke encephalopathy is suspected.
Carl Wernicke: Carl Wernicke was a German neurologist who described an acute encephalopathy associated with lesions around the third and fourth ventricles. His 1881 description gave the disorder its eponym.
Alcohol withdrawal delirium: Alcohol withdrawal delirium is an acute confusional state with autonomic overactivity arising after cessation or reduction of heavy alcohol use. It can coexist with Wernicke encephalopathy, so confusion in alcohol withdrawal should not be attributed to withdrawal alone.
Confabulation: Confabulation is the production of false or distorted memories without conscious intent to deceive. It can accompany the chronic amnestic state that follows severe thiamine-related injury.
Blood–brain barrier: The blood–brain barrier is a selective interface that regulates movement of substances between blood and the central nervous system. Thiamine transport across this barrier helps explain how deficiency affects the brain.
Magnetic resonance imaging: Magnetic resonance imaging uses magnetic fields and radio waves to produce detailed images of internal structures. MRI can reveal symmetric signal abnormalities, but a normal scan does not exclude the disorder.
Sergei Korsakoff: Sergei Korsakoff was a Russian psychiatrist who described a chronic amnestic syndrome associated with alcoholism and nutritional illness. His work established the chronic memory syndrome now linked to the same thiamine-deficiency spectrum.
Hepatic encephalopathy: Hepatic encephalopathy is reversible brain dysfunction caused by liver failure or portosystemic shunting. Both can cause confusion and impaired coordination, but hepatic dysfunction drives the latter.
Anterograde amnesia: Anterograde amnesia is impaired formation of new memories after the onset of brain injury or illness. Persistent memory-encoding deficits are a defining consequence of progression to Korsakoff syndrome.

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