Serious Indicators Of Wernicke's Encephalopathy

Wernicke's encephalopathy is one of two conditions, the other being Korsakoff syndrome, that often occur together. The overarching condition is called Wernicke-Korsakoff syndrome, and researchers believe they may be different stages of one disease. The conditions occur when individuals don't get enough thiamine, otherwise known as vitamin B1. This vitamin is necessary for the brain to convert sugar into usable energy.

If the nervous system and brain aren't getting the amount of energy they need, they won't function well. Wernicke's encephalopathy tends to occur suddenly and requires immediate treatment. When treatment doesn't occur in a timely manner, the illness can progress to Korsakoff syndrome, which occurs more slowly and causes ongoing brain damage.

Ataxia

Ataxia is a condition that occurs when the nervous system's functioning degenerates. Individuals with ataxia may look like they're drunk, as they tend to stumble, fall, lack coordination, and slur their words. These symptoms are caused by degeneration of the cerebellum, which coordinates a person's movements. There are a number of diseases under the ataxia umbrella that present with the condition alone, but the onset of the condition can also indicate an underlying problem. With Wernicke's encephalopathy, a severe thiamine deficiency has led the brain's functions to degenerate because there's not enough energy.

Ataxia patients often have wide stances and take short steps because of their trouble balancing. They may need others to help them stand up and move around. Patients may also experience general weakness in the legs and arms. Even if the cause isn't Wernicke's encephalopathy, the sudden onset of these symptoms is a serious sign something is neurologically wrong. If individuals experience these symptoms without warning or explanation, they should seek emergency medical treatment.

Confusion

Confusion is another one of the major symptoms of Wernicke's encephalopathy. Patients with this symptom may be confused about what's going on around them. They might have trouble following a conversation, remembering where they are, or remembering what they're doing. The confusion might be accompanied by a general loss of interest in the outside world.

Wernicke's encephalopathy patients sometimes find it's too difficult to sort through the mental fog, and they don't have the will to connect to the outside world. This kind of mental confusion is another symptom that occurs because of the brain's decreased ability to function. Thought processes and interpretation of sensory data both become muddled, and the ability to feel emotions may also be somewhat dulled.

Ophthalmoplegia

Eye problems are the third major symptom of Wernicke's encephalopathy. With ophthalmoplegia, the eye muscles become weak or completely paralyzed. There are six muscles that control the movement of the eyes, and this condition might affect one or more. The most common symptoms are blurring or double vision. Some individuals might have difficulty positioning their eyes in sync, or they may find this completely impossible. Many patients present with drooping eyelids. The most common causes of ophthalmoplegia are multiple sclerosis, trauma, muscle disorders, or mitochondrial diseases.

However, brain injuries and nervous system degeneration like what's seen in Wernicke's encephalopathy can also lead to this. Infections, brain tumors, strokes, migraines, and thyroid diseases may also be underlying causes. The condition can often be treated, but patients with Wernicke's encephalopathy must have their underlying thiamine deficiency treated to keep the condition from progressing.

Vision Or Hearing Loss

Wernicke's encephalopathy can present with vision or hearing loss. Vision loss tends to be related to the eye abnormalities. If a patient's eye muscles are weak or paralyzed, and their eyes are misaligned, they may not be able to interpret visual data correctly. Hearing loss, on the other hand, tends to occur more rarely. It's only been recorded in a handful of cases, but the correlation is significant enough that researchers recommend considering Wernicke's encephalopathy as a diagnosis when patients present with hearing loss, eye abnormalities, ataxia, and confusion.

In one study, a sixty-one-year-old woman had acute hearing loss in both ears followed by acute and vague disturbances in her vision. In fact, the hearing loss was severe enough that she was almost deaf. After she was treated with IV thiamine, her hearing, eye movements, and cognition became markedly improved within just twelve hours. She had almost returned to her baseline after the first twenty-four hours of treatment.

Retinal Hemorrhage

Retinal hemorrhage occurs when there's bleeding inside the retina, which is responsible for interpreting visual data. There are a number of medical conditions that might lead to retinal hemorrhage, including blockage of a retinal vein, hypertension, leukemia, anemia, and diabetes mellitus. Though hemorrhages that occur outside the eye's macula might not be detected for years, others can cause severe vision impairment. Another condition that may occur is optic disk edema, which causes the optic disk to swell because of an increase in pressure inside the skull. Though these aren't the most common eye abnormalities in Wernicke's encephalopathy, they're still significant. Hemorrhages need immediate treatment if they've caused serious vision impairment.