Neurology · UKMLA & AKT

Wernicke's encephalopathy

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise wernicke's encephalopathy — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • Acute, potentially reversible neuropsychiatric emergency caused by thiamine (vitamin B1) deficiency
  • Classically associated with chronic alcohol misuse - but any cause of severe nutritional deficiency can trigger it (post-bariatric surgery, hyperemesis gravidarum, prolonged vomiting/malnutrition)
  • Thiamine is an essential cofactor for aerobic carbohydrate metabolism - deficiency causes intracellular energy failure and selective neuronal injury

Giving IV glucose to a thiamine-depleted patient accelerates thiamine consumption and can precipitate or worsen Wernicke's. Always give thiamine before or simultaneously with glucose in any at-risk patient.

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