Wernicke's encephalopathy: 'Plus ça change, plus c'est la même chose'.
OBJECTIVE
To develop clinical guidelines to identify individuals who misuse alcohol and are at risk of developing Wernicke's Encephalopathy (WE).


METHODS
Non-systematic literature review of studies which includes a careful clinical record of the development of signs and symptoms of thiamine deficiency and in which the diagnosis of WE has been confirmed at autopsy.


RESULTS
The review of the clinical findings in cases of WE, diagnosed at autopsy, shows a consistent pattern of signs and symptoms. The pattern appears to be similar regardless of whether the thiamine deficiency is related to nutritional problems alone or associated with alcohol misuse.


CONCLUSIONS
The assessment of the degree of thiamine deficiency and the diagnosis of WE remain a clinical evaluation, and guidelines are suggested to help the clinician. Since neurotoxicity due to the metabolism of excessive alcohol in patients with chronic and severe alcohol dependence may be an important factor in determining long-term outcome of treatment, this must form part of the overall evaluation.
Thomson
Allan D
AD
Molecular Psychiatry Laboratory, Windeyer Institute of Medical Science, Department of Mental Health Sciences, Royal Free and University College London, Medical School, 46 Cleveland Street, London W1T 4JF, UK.
Cook
Christopher C H
CC
Guerrini
Irene
I
Sheedy
Donna
D
Harper
Clive
C
Marshall
E Jane
EJ
D000437:Alcoholism / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards; D013832:Thiamine Deficiency / Q000150:complications / Q000175:diagnosis; D014899:Wernicke Encephalopathy / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control