Neurology · UKMLA & AKT
Wernicke's encephalopathy
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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