Hello again. Wernicke Encephalopathy is a neurological disease caused by a deficiency
of thiamine in the brain. It was first described by Carl Wernicker in 1881. There is a triad of
symptoms which include confusion, ataxia - which is problems with the voluntary movement of muscles
and may lead to problems walking - and eye abnormalities. The most common cause is chronic
consumption of excess alcohol. Wernicke's encephalopathy is also known as Wernicke's
disease, Wernicke-Korsakoff syndrome - as if left untreated, Wernicke's encephalopathy
can then lead to Korsakoff syndrome - Gayet- Wernicke syndrome, alcohol-induced encephalopathy
and wet brain syndrome - as the condition causes intense swelling of the brain. I'm Dr Beth Colby,
a psychiatrist in London. In this video, I'm going to talk about the importance of thiamine in brain
function and the causes, symptoms, treatment and prevention of Wernicke's encephalopathy.
Thiamine is used to break down glucose, which is the main source of energy for the brain.
A deficiency of thiamine affects brain functions, including the activity of the hypothalamus which
regulates temperature, appetite, emotions and growth. Lack of thiamine affects the cells of
the central and peripheral nervous system and also the cardiovascular system more than the cells of
other organ systems. As I've said, the most common cause of Wernicke's encephalopathy is chronic
consumption of excess alcohol. This is because people who drink too much tend to have a poor diet
and therefore there is a lack of thymine ingested. Furthermore, alcohol also prevents
thiamine absorption from the gastrointestinal tract, stops it being properly used in cells,
increases the loss of thiamine in the urine, and stops the storage of thiamine in the liver.
Wernicke's encephalopathy can also be caused by conditions causing a deficiency of thiamine in
the diet or decreased absorption of thiamine. These include starvation, eating disorders,
gastric bypass surgery - and that's because it's difficult to meet nutritional needs due
to small portions - stomach cancer which leads to decreased absorption of important nutrients,
and colon cancer which may lead to pain that will make people want to eat less. Now on to symptoms;
as I've said, the 3 main symptoms are confusion, ataxia and eye abnormalities. An individual may
not necessarily have all 3 symptoms. However, most people will be confused and disorientated. The
confusion and disorientation may take place over several days or months. A person may experience
lethargy, loss of attention and drowsiness, which may lead to aggression and violence. If left
untreated, a person will become unconscious and go into a coma. A person with ataxia has a slow
and steady gait due to poor balance and often will walk with legs wide apart. Some individuals
will not be able to stand or walk without assistance. As regarding eye abnormalities,
people with Wernicke's encephalopathy have difficulty controlling their eye movements.
The ocular abnormalities include double vision, rapid involuntary eye movements such as up and
down or side to side - this is known as nystagmus - paralysis of certain eye muscles - which is
known as ophthalmoplegia - and rarely drooping of the upper eyelids - which is known as
ptosis - P T O S I S. A person with Wernicke's encephalopathy will either be very underweight
or have a history of losing a lot of weight in the previous few months.
As I said, Wernicke's encephalopathy can lead to coma, and it can also lead to death, and this
occurs in 10 to 20% of patients with Wernicke's encephalopathy. about 80% of patients with
Wernicke's encephalopathy go on to get Korsakoff syndrome, and the symptoms of this tend to develop
as the symptoms of Wernicke's encephalopathy subside. Korsakoff's syndrome is characterized
by short-term memory loss - that's the inability to make new memories and remember new information;
rarely individuals attempt to fill gaps in their memory by creating imaginary events,
and this is called 'confabulation.' Treatment. Wernicke'sencephalopathy is
usually treated in hospital, as intravenous thiamine needs to be administered.
The quicker the Wernicke's encephalopathy is treated, the better the outcome.
The patient also needs to immediately stop drinking alcohol,
so an injection of high-dose thiamine and other vitamins is given to the patient, and this will
be repeated. It's given intravenously initially, as there may be impairment of absorption from
the gastrointestinal tract. However, oral thiamine will be started at the same time
and continued for several months, along with other essential nutrients. The confusion,
ataxia and problems with eye movements will usually improve when thiamine is administered.
Different specialists may be involved in treating the patient. These include neurology, psychiatry,
ophthalmology, cardiology and gastroenterology. Some people will benefit from psychotherapies.
Patients who have problems with movement and gait will benefit from physiotherapy. Once somebody has
been treated for Wernicke's encephalopathy, it's important that they get referred to an alcohol
service to help them stop drinking alcohol. People can avoid Wernicke Korsakoff syndrome
by staying away from alcohol and eating a balanced diet rich in thiamine or vitamin B1.
oFods rich in vitamin B1 include rice, peas, whole wheat bread,spinach, oranges, milk and lean pork.
I hope this has been useful and of interest. Please 'like' and subscribe, and 'bye for now.