Complications
These persistent manifestations of Wernicke's encephalopathy may be seen if the condition is not recognised or sufficient doses of thiamine are not administered or have been delayed.
Ophthalmoplegia is likely to be the first sign to respond following thiamine repletion, with complete recovery after a few hours except for a residual fine horizontal nystagmus in up to 60% of patients.[17] Ataxia may resolve over several days but can be incomplete.
An anterograde and retrograde amnestic syndrome with disproportionate impairment of recent memory relative to other cognitive domains. Also characterised by confabulation, apathy, and behavioural changes.[3] Autopsy studies have shown degeneration of memory circuits especially involving the mammillary bodies and dorsomedial thalami. Not all patients with Wernicke's encephalopathy develop this complication; neither do all patients with Korsakoff's psychosis have preceding Wernicke's encephalopathy. After treatment with adequate doses of thiamine, 25% show no recovery, 25% show slight recovery, 25% show significant recovery, and 25% show complete recovery of memory deficits.[90]
May occur as an uncommon symptom at presentation or if Wernicke's encephalopathy is not adequately treated.[23]
May occur as an uncommon sign at presentation or if Wernicke's encephalopathy is not adequately treated.[23]
May occur as an uncommon sign at presentation or if Wernicke's encephalopathy is not adequately treated.[23]
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