Comprehensive review of Wernicke encephalopathy: pathophysiology, clinical symptoms and imaging findings
- PMID: 32390125
- DOI: 10.1007/s11604-020-00989-3
Comprehensive review of Wernicke encephalopathy: pathophysiology, clinical symptoms and imaging findings
Abstract
Wernicke's encephalopathy (WE) is a severe and life-threatening illness resulting from vitamin B1 (thiamine) deficiency. The prevalence of WE has been estimated from 0.4 to 2.8%. If not treated properly, severe neurologic disorders such as Korsakoff psychosis and even death may occur. The classical triad of clinical symptoms (abnormal mental state, ataxia, and ophthalmoplegia) is found in only 16-33% of patients on initial examination. The originally described underlying condition of WE is alcoholism, but it accounts for about 50% of causes of WE. Nonalcoholic patients are also affected by WE and likely to present symptoms and radiological imaging findings different from patients with alcoholism, which further complicates the diagnosis of WE. Being familiar with predisposing causes, symptoms and radiological imaging findings of WE is important for radiologists and clinicians when making the diagnosis to start immediate treatment. This review discusses pathophysiologies, underlying causes, clinical symptoms, imaging findings and their mimics.
Keywords: Complications; Cytotoxic and vasogenic edema; MRI; Thiamine; Wernicke encephalopathy.
References
-
- Latt N, Dore G. Thiamine in the treatment of Wernicke encephalopathy in patients with alcohol use disorders. Intern Med J. 2014;44(9):911–5. - DOI
-
- Lough ME. Wernicke's encephalopathy: expanding the diagnostic toolbox. Neuropsychol Rev. 2012;22(2):181–94. https://doi.org/10.1007/s11065-012-9200-7 . - DOI - PubMed
-
- Galvin R, Brathen G, Ivashynka A, Hillbom M, Tanasescu R, Leone MA. EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. Eur J Neurol. 2010;17(12):1408–18. https://doi.org/10.1111/j.1468-1331.2010.03153.x . - DOI - PubMed
-
- Ogershok PR, Rahman A, Nestor S, Brick J. Wernicke encephalopathy in nonalcoholic patients. Am J Med Sci. 2002;323(2):107–11. - DOI
-
- Chandrakumar A, Bhardwaj A, Jong GW. Review of thiamine deficiency disorders: Wernicke encephalopathy and Korsakoff psychosis. J Basic Clin Physiol Pharmacol. 2018;30(2):153–62. https://doi.org/10.1515/jbcpp-2018-0075 . - DOI - PubMed
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