Tuesday, April 18, 2006

Wernicke's Encephalopathy

Tuesday April 18, 2006
Wernicke's Encephalopathy in ICU

Q: Can Wernicke's Encephalopathy be iatrogenic in ICU ?

A: Yes, it can be precipitated in any patient by glucose (like D-5, D-10 or D-50) administration who is thiamine deficient. It is not limited to alcoholics and can happen in any nutritionally deficient patient. It is always a good idea to add thiamine in D-5 drip in patients who are at risk of Wernicke's Encephalopathy.
Disorder was described about 25 years ago by Carl Wernicke as a triad of

  • acute mental confusion
  • ataxia
  • opthalmoplegia

Read a case of Wernicke's encephalopathy. in a non-alcoholic patient with MRI findings
here (Ref.: The New England Journal of Medicine, Kaineg and Hudgins 352 (19): e18, May 12, 2005)

Also full review article
Wernicke's encephalopathy from Philip Salen, MD at emedicine.com