Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy.

Abstract

A recent necropsy study has shown that 80% of patients with the Wernicke-Korsakoff syndrome were not diagnosed as such during life. Review of the clinical signs of these cases revealed that only 16% had the classical clinical triad and 19% had no documented clinical signs. The incidence of clinical signs in this and other retrospective pathological studies is very different from that of prospective clinical studies. This discrepancy may relate to "missed" clinical signs but the magnitude of the difference suggests that at least some cases of the Wernicke-Korsakoff syndrome may be the end result of repeated subclinical episodes of vitamin B 1 deficiency. In order to make the diagnosis, clinicians must maintain a high index of suspicion in the "at risk" group of patients, particularly alcoholics. Investigations of thiamine status may be helpful and if the diagnosis is suspected, parenteral thiamine should be given.

Wernicke Encephalopathy: MR Findings at Clinical Presentation in Twenty-Six Alcoholic and Nonalcoholic Patients

“…1,2 Neuroradiologic findings usually show symmetric signal intensity alterations in the mamillary bodies, medial thalami, tectal plate, and periaqueductal area. 3 WE results from a deficiency of vitamin B1 (thiamine).…”

“…6 WE represents a medical emergency, and treatment consists of intravenous administration of thiamine. 1,2 The classic clinical triad of WE is not always present at clinical onset. 2 Thus, diagnostic imaging modalities are useful to achieve a prompt diagnosis and treatment.…”

An atypical presentation of Wernicke's encephalopathy in an 11-year-old child

“…6 In the paediatric population, the classical triad was present in only 21.4% at onset. 5 Mortality in Wernicke's encephalopathy has been reported from 10 to 20%, therefore prompt recognition of the condition and early treatment are vital.…”

Wernicke’s Encephalopathy in A Young Adult Affected by T Cell Acute Lymphoblastic Leukemia and Ileotiphlytis with Review of the Literature

“…The WE is characterized by a classic triad: encephalopathy, oculomotor dysfunction and gait ataxia. Rarely the whole triad is present in the same patient [1,5]. Therefore, the clinical diagnosis is hard; as a consequence, the syndrome is still significantly missed.…”