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Wernicke encephalopathy

MedGen UID:
53073
•Concept ID:
C0043121
•
Disease or Syndrome
Synonyms: Beriberi, Cerebral; Cerebral Beriberi; Encephalopathies, Wernicke; Encephalopathy, Gayet Wernicke; Encephalopathy, Gayet-Wernicke; Encephalopathy, Wernicke; Encephalopathy, Wernicke's; Encephalopathy, Wernickes; Gayet Wernicke Encephalopathy; Gayet-Wernicke Encephalopathy; Wernicke Disease; Wernicke Encephalopathies; Wernicke Encephalopathy; Wernicke Polioencephalitis, Superior Hemorrhagic; Wernicke Superior Hemorrhagic Polioencephalitis; Wernicke Syndrome; Wernicke's Disease; Wernicke's Encephalopathy; Wernicke's Polioencephalitis, Superior Hemorrhagic; Wernicke's Superior Hemorrhagic Polioencephalitis; Wernicke's Syndrome
SNOMED CT: Wernicke disease (21007002); Wernicke's disease (21007002); Wernicke's encephalopathy (21007002)
 
Monarch Initiative: MONDO:0007020
Orphanet: ORPHA97354

Definition

An acute neurological disorder characterized by the triad of ophthalmoplegia, ataxia, and disturbances of mental activity or consciousness. Eye movement abnormalities include nystagmus, external rectus palsies, and reduced conjugate gaze. thiamine deficiency and chronic alcoholism are associated conditions. Pathologic features include periventricular petechial hemorrhages and neuropil breakdown in the diencephalon and brainstem. Chronic thiamine deficiency may lead to korsakoff syndrome. (Adams et al., Principles of Neurology, 6th ed, pp1139-42; Davis & Robertson, Textbook of Neuropathology, 2nd ed, pp452-3) [from MONDO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVWernicke encephalopathy

Professional guidelines

PubMed

CLINICAL PRACTICE GUIDELINES FOR THE PERIOPERATIVE NUTRITION, METABOLIC, AND NONSURGICAL SUPPORT OF PATIENTS UNDERGOING BARIATRIC PROCEDURES - 2019 UPDATE: COSPONSORED BY AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY, THE OBESITY SOCIETY, AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY, OBESITY MEDICINE ASSOCIATION, AND AMERICAN SOCIETY OF ANESTHESIOLOGISTS - EXECUTIVE SUMMARY.
Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J, Kushner RF, Lindquist R, Pessah-Pollack R, Seger J, Urman RD, Adams S, Cleek JB, Correa R, Figaro MK, Flanders K, Grams J, Hurley DL, Kothari S, Seger MV, Still CD
Endocr Pract 2019 Dec;25(12):1346-1359. Epub 2019 Nov 4 doi: 10.4158/GL-2019-0406. PMID: 31682518
Thiamine in the treatment of Wernicke encephalopathy in patients with alcohol use disorders.
Latt N, Dore G
Intern Med J 2014 Sep;44(9):911-5. doi: 10.1111/imj.12522. PMID: 25201422
EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy.
Galvin R, Bråthen G, Ivashynka A, Hillbom M, Tanasescu R, Leone MA; EFNS
Eur J Neurol 2010 Dec;17(12):1408-18. doi: 10.1111/j.1468-1331.2010.03153.x. PMID: 20642790

Recent clinical studies

Etiology

Alcohol-Related Metabolic Emergencies.
Knight-Dunn L, Gorchynski J
Emerg Med Clin North Am 2023 Nov;41(4):809-819. doi: 10.1016/j.emc.2023.07.003. PMID: 37758425
Updated results of the placebo-controlled, phase III JAKARTA trial of fedratinib in patients with intermediate-2 or high-risk myelofibrosis.
Pardanani A, Tefferi A, Masszi T, Mishchenko E, Drummond M, Jourdan E, Vannucchi A, Jurgutis M, Ribrag V, Rambaldi A, Koh LP, Rose S, Zhang J, Harrison C
Br J Haematol 2021 Oct;195(2):244-248. Epub 2021 Jul 30 doi: 10.1111/bjh.17727. PMID: 34331348Free PMC Article
Prion Disease.
Baldwin KJ, Correll CM
Semin Neurol 2019 Aug;39(4):428-439. Epub 2019 Sep 18 doi: 10.1055/s-0039-1687841. PMID: 31533183
Role of Thiamin in Health and Disease.
Polegato BF, Pereira AG, Azevedo PS, Costa NA, Zornoff LAM, Paiva SAR, Minicucci MF
Nutr Clin Pract 2019 Aug;34(4):558-564. Epub 2019 Jan 15 doi: 10.1002/ncp.10234. PMID: 30644592
Alcoholic metabolic emergencies.
Allison MG, McCurdy MT
Emerg Med Clin North Am 2014 May;32(2):293-301. Epub 2014 Feb 19 doi: 10.1016/j.emc.2013.12.002. PMID: 24766933

Diagnosis

Wernicke Encephalopathy.
Saghir K, Louhab N, Kissani N
Dtsch Arztebl Int 2022 Jul 11;119(27-28):483. doi: 10.3238/arztebl.m2022.0030. PMID: 36342089Free PMC Article
Prion Disease.
Baldwin KJ, Correll CM
Semin Neurol 2019 Aug;39(4):428-439. Epub 2019 Sep 18 doi: 10.1055/s-0039-1687841. PMID: 31533183
Wernicke's encephalopathy.
Robinson K
Emerg Nurse 2003 Sep;11(5):30-3. doi: 10.7748/en2003.09.11.5.30.c1134. PMID: 14533298
Wernicke-Korsakoff syndrome.
Zubaran C, Fernandes JG, Rodnight R
Postgrad Med J 1997 Jan;73(855):27-31. doi: 10.1136/pgmj.73.855.27. PMID: 9039406Free PMC Article
Wernicke's encephalopathy.
Handler CE, Perkin GD
J R Soc Med 1983 May;76(5):339-42. doi: 10.1177/014107688307600502. PMID: 6864698Free PMC Article

Therapy

Wernicke's Encephalopathy.
Xia J, Li J
Neurol India 2023 May-Jun;71(3):626-627. doi: 10.4103/0028-3886.378682. PMID: 37322794
Wernicke encephalopathy.
Fujikawa T, Sogabe Y
CMAJ 2020 Feb 10;192(6):E143. doi: 10.1503/cmaj.190998. PMID: 32041699Free PMC Article
Nonalcoholic Wernicke's encephalopathy.
Welsh A, Rogers P, Clift F
CJEM 2016 Jul;18(4):309-12. Epub 2015 May 19 doi: 10.1017/cem.2015.27. PMID: 25985980
Wernicke's encephalopathy.
Robinson K
Emerg Nurse 2003 Sep;11(5):30-3. doi: 10.7748/en2003.09.11.5.30.c1134. PMID: 14533298
Wernicke-Korsakoff syndrome.
Zubaran C, Fernandes JG, Rodnight R
Postgrad Med J 1997 Jan;73(855):27-31. doi: 10.1136/pgmj.73.855.27. PMID: 9039406Free PMC Article

Prognosis

Updated results of the placebo-controlled, phase III JAKARTA trial of fedratinib in patients with intermediate-2 or high-risk myelofibrosis.
Pardanani A, Tefferi A, Masszi T, Mishchenko E, Drummond M, Jourdan E, Vannucchi A, Jurgutis M, Ribrag V, Rambaldi A, Koh LP, Rose S, Zhang J, Harrison C
Br J Haematol 2021 Oct;195(2):244-248. Epub 2021 Jul 30 doi: 10.1111/bjh.17727. PMID: 34331348Free PMC Article
Nonalcoholic Wernicke's encephalopathy.
Welsh A, Rogers P, Clift F
CJEM 2016 Jul;18(4):309-12. Epub 2015 May 19 doi: 10.1017/cem.2015.27. PMID: 25985980
Alcoholic metabolic emergencies.
Allison MG, McCurdy MT
Emerg Med Clin North Am 2014 May;32(2):293-301. Epub 2014 Feb 19 doi: 10.1016/j.emc.2013.12.002. PMID: 24766933
Wernicke-Korsakoff encephalopathy.
Pearce JM
Eur Neurol 2008;59(1-2):101-4. Epub 2007 Oct 11 doi: 10.1159/000109580. PMID: 17934284
Wernicke-Korsakoff syndrome.
Zubaran C, Fernandes JG, Rodnight R
Postgrad Med J 1997 Jan;73(855):27-31. doi: 10.1136/pgmj.73.855.27. PMID: 9039406Free PMC Article

Clinical prediction guides

Wernicke-Kleist-Leonhard phenotypes 
of endogenous psychoses: a review of their validity
.
Foucher JR, Gawlik M, Roth JN, de Crespin de Billy C, Jeanjean LC, Obrecht A, Mainberger O, Clauss JME, Elowe J, Weibel S, Schorr B, Cetkovich M, Morra C, Rebok F, Ban TA, Bollmann B, Roser MM, Hanke MS, Jabs BE, Franzek EJ, Berna F, Pfuhlmann B
Dialogues Clin Neurosci 2020 Mar;22(1):37-49. doi: 10.31887/DCNS.2020.22.1/jfoucher. PMID: 32699504Free PMC Article
Wernicke's encephalopathy after cardiac surgery.
Nishimura Y
Asian Cardiovasc Thorac Ann 2018 May;26(4):302-304. Epub 2018 Apr 18 doi: 10.1177/0218492318772693. PMID: 29667898
Cerebellar neurocognition and Korsakoff's syndrome: an hypothesis.
Wijnia JW, Goossensen A
Med Hypotheses 2010 Aug;75(2):266-8. Epub 2010 Mar 29 doi: 10.1016/j.mehy.2010.02.035. PMID: 20303220
Death in Unverricht-Lundborg disease.
Khiari HM, Franceschetti S, Jovic N, Mrabet A, Genton P
Neurol Sci 2009 Aug;30(4):315-8. Epub 2009 Jun 5 doi: 10.1007/s10072-009-0102-2. PMID: 19499178
Metronidazole-induced encephalopathy.
Kim DW, Park JM, Yoon BW, Baek MJ, Kim JE, Kim S
J Neurol Sci 2004 Sep 15;224(1-2):107-11. doi: 10.1016/j.jns.2004.06.012. PMID: 15450780

Recent systematic reviews

Diagnosis and treatment of Wernicke's encephalopathy: A systematic literature review.
Cantu-Weinstein A, Branning R, Alamir M, Weleff J, Do M, Nero N, Anand A
Gen Hosp Psychiatry 2024 Mar-Apr;87:48-59. Epub 2024 Feb 1 doi: 10.1016/j.genhosppsych.2024.01.005. PMID: 38306946
Wernicke's Encephalopathy in Acute and Chronic Kidney Disease: A Systematic Review.
Oudman E, Wijnia JW, Severs D, Oey MJ, van Dam M, van Dorp M, Postma A
J Ren Nutr 2024 Mar;34(2):105-114. Epub 2023 Oct 13 doi: 10.1053/j.jrn.2023.10.003. PMID: 37838073
Wernicke Encephalopathy Presenting with Dysphagia: A Case Report and Systematic Literature Review.
Cornea A, Lata I, Simu M, Rosca EC
Nutrients 2022 Dec 13;14(24) doi: 10.3390/nu14245294. PMID: 36558453Free PMC Article
Wernicke Encephalopathy in schizophrenia: a systematic review.
Oudman E, Wijnia JW, Oey MJ, van Dam MJ, Postma A
Int J Psychiatry Clin Pract 2021 Sep;25(3):233-237. Epub 2020 Sep 21 doi: 10.1080/13651501.2020.1819333. PMID: 32957818
Preventing Wernicke's encephalopathy in anorexia nervosa: A systematic review.
Oudman E, Wijnia JW, Oey MJ, van Dam MJ, Postma A
Psychiatry Clin Neurosci 2018 Oct;72(10):774-779. Epub 2018 Jul 31 doi: 10.1111/pcn.12735. PMID: 29984541

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