Wernicke Encephalopathy


Clinical features lone or with MRI findings or low B1 levels
+/-Response to thiamine treatment
+/-B1 Thiamine: by functional transketolase assay, thiamine chromatography or urinary thiamine

Clinical features:


  • Confusion, ataxia, ophthalmoplegia
  • Not all features are necessary. Occasionally hypothermia occurs.

Findings on Investigations:

MRI features:

  • Hyperintense signals in the periaqueductal gray area, dorsal medial nucleus of the thalamus and the mammilary bodies
  • Hyperintensity of the mammillothalamic tracts.

Investigations to consider:

B1 Thiamine level


Thiamine, initially 100 mg intravenously multiple times a day, then orally

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