Wernicke Encephalopathy - Acute B1 (Thiamine) Deficiency - Diagnosis and Management
Diagnosis - Caine Criteria (2 of 4):
 • Changes in mental status or memory impairment
 • Oculomotor dysfunctions ( e.g. ophthalmoplegia and nystagmus)
 • Cerebellar dysfunction (e.g. gait ataxia - usually not present in upper limb)
 • Nutritional deficiency
Why? Any risk factor for nutritional deficiency!
 • Chronic alcoholism
 • Malignancy
 • Hyperemesis of pregnancy
 • Bariatric surgery
 • Anorexia nervosa
Treatment - Intravenous thiamine infusion:
• Administration of glucose without thiamine can worsen Wernicke Encephalopathy
• A prompt treatment can improve symptoms and prevent the development of Korsakoff syndrome (chronic B1 deficiency)

By Dr. Gabriela Figueiredo Pucci @gabifpucci @neudrawlogy

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