Wernicke Encephalopathy (Wernicke's Encephalopathy)

An acute neurological disorder characterized by the triad of ophthalmoplegia, ataxia, and disturbances of mental activity or consciousness. Eye movement abnormalities include nystagmus, external rectus palsies, and reduced conjugate gaze. THIAMINE DEFICIENCY and chronic ALCOHOLISM are associated conditions. Pathologic features include periventricular petechial hemorrhages and neuropil breakdown in the diencephalon and brainstem. Chronic thiamine deficiency may lead to KORSAKOFF SYNDROME. (Adams et al., Principles of Neurology, 6th ed, pp1139-42; Davis & Robertson, Textbook of Neuropathology, 2nd ed, pp452-3)

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Networked: 387 relevant articles (10 outcomes, 14 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

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3.	Beriberi
4.	Neurologic Manifestations (Neurological Manifestations)
5.	Alcohol Withdrawal Delirium (Delirium Tremens)

Experts

1.	Hazell, Alan S: 7 articles (06/2014 - 08/2003)
2.	Butterworth, Roger F: 4 articles (12/2010 - 03/2008)
3.	Sullivan, Edith V: 3 articles (11/2014 - 05/2007)
4.	Zahr, Natalie M: 3 articles (11/2014 - 02/2011)
5.	Pfefferbaum, Adolf: 3 articles (11/2014 - 05/2007)
6.	Wang, Dongmei: 3 articles (06/2014 - 01/2010)
7.	Desjardins, Paul: 3 articles (12/2010 - 06/2008)
8.	Zuccoli, Giulio: 3 articles (06/2010 - 04/2008)
9.	Zuccoli, G: 3 articles (01/2009 - 08/2007)
10.	Han, Jung Woo: 2 articles (11/2014 - 09/2012)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Wernicke Encephalopathy:

1.	Thiamine (Aneurin)FDA Link 01/01/2015 - "Wernicke encephalopathy was suspected according to his symptoms, and thiamine administration dramatically improved his condition. " 05/01/2000 - "Failure of large oral doses of thiamine hydrochloride to provide an effective treatment for Wernicke's encephalopathy emphasizes the need for adequate and rapid replacement of depleted brain thiamine levels by repeated parenteral therapy in adequate doses." 01/01/2011 - "Timing of efficacy of thiamine in Wernicke's disease in alcoholics at risk." 03/01/1984 - "The Wernicke's encephalopathy responded well to the administration of thiamine. " 03/01/1995 - "The present study examined the cytopathological changes within diencephalon of a rat model of Wernicke's encephalopathy and determined whether administration of thiamine at various intervals after onset of neurological signs can arrest or reverse the cytopathological process. "
2.	TransketolaseIBA 01/01/1986 - "Recent data demonstrating normal levels of erythrocyte transketolase in patients presenting with Wernicke's encephalopathy has led some to question the link between thiamin deficiency, and the development of the syndrome, despite the fact that virtually all patients with Wernicke's encephalopathy will respond favorably to parenteral thiamin, and the evidence that rats deprived of thiamin develop lesions that are characteristic of the disease. " 11/01/1986 - "We found that the above-mentioned patient and one of the diabetic kindreds with no history of Wernicke's encephalopathy had abnormal transketolase as determined by its Km for TPP. " 11/30/1990 - "The relationship between erythrocyte transketolase activity and the 'TPP effect' in Wernicke's encephalopathy and other thiamine deficiency states." 07/01/2002 - "Both patients were diagnosed with Wernicke's encephalopathy on clinical ground since there were no laboratory facilities to measure red cell transketolase and thiamine pyrophosphate levels. " 07/01/1999 - "Also discussed are new findings on the molecular genetics of the thiamine-dependent enzyme transketolase in patients with Wernicke encephalopathy. "
3.	VitaminsIBA 10/01/2012 - "Vitamin prescription for the prevention and treatment of Wernicke's encephalopathy." 01/12/2006 - "The prevention and treatment of Wernicke's encephalopathy by parenteral and oral vitamin supplementation is also given a high priority in the guidelines. " 11/12/2003 - "As a consequence from the guideline for managing Wernicke's encephalopathy by the Royal College of Physicians early B-vitamin treatment in suspected is recommended cases." 01/01/2000 - "The change of our national health insurance policy in 1992 discouraged the routine administration of vitamins, probably causing Wernicke's encephalopathy in our patients." 01/01/2000 - "We report 4 nonalcoholic patients with such Wernicke's encephalopathy, which occurred during the early postoperative oral food intake period following intravenous nutrition without vitamin supplements. "
4.	Glucose (Dextrose)FDA LinkGeneric 04/01/2012 - "True clinical research about the question of whether or not a glucose load can precipitate acute onset of Wernicke encephalopathy is lacking. " 02/10/2004 - "Wernicke's encephalopathy after glucose infusion." 02/16/2001 - "The timed acute changes that follow a bolus glucose load administered to thiamin-deficient animals may provide a sequential account of events in the pathogenesis of brain damage in this model of Wernicke's encephalopathy." 02/16/2001 - "Glucose loading of rats made thiamin deficient by dietary deprivation of thiamin and the administration of pyrithiamin (40 microg/100 g, i.p.) precipitates an acute neuropathy, a model of Wernicke's encephalopathy in man (Zimitat and Nixon, Metab. " 03/01/1999 - "A rat model of glucose-precipitated Wernicke's encephalopathy (WE) has been developed in which glucose loading (10 g/kg, i.p.) of ataxic thiamin-deficient (TD) rats induced episodes of gross neurological dysfunction and sometimes death. "
5.	PyrithiamineIBA 03/10/2000 - "The current study examined the possible role of increased histamine release and granulocyte activity in the vascular changes that precede the onset of necrotic lesions with the thalamus of the pyrithiamine-induced thiamine deficiency (PTD) rat model of Wernicke's encephalopathy (WE). " 04/12/1996 - "Pyrithiamine-induced thiamine deficiency in the rat exhibits many neuropathological and biochemical similarities to Wernicke's Encephalopathy in human. " 04/01/1989 - "Pyrithiamine-induced thiamine-deficiency encephalopathy in the rat shows many neuropathological and biochemical similarities to Wernicke's encephalopathy in humans. " 10/01/1988 - "Reversible alterations of cerebral gamma-aminobutyric acid in pyrithiamine-treated rats: implications for the pathogenesis of Wernicke's encephalopathy." 08/01/2003 - "Pyrithiamine-induced thiamine deficiency (TD) is a well-established model of Wernicke's encephalopathy in which a glutamate-mediated excitotoxic mechanism may play an important role in determining selective vulnerability. "
6.	Thiamine PyrophosphateIBA 07/01/2002 - "Both patients were diagnosed with Wernicke's encephalopathy on clinical ground since there were no laboratory facilities to measure red cell transketolase and thiamine pyrophosphate levels. " 08/01/1995 - "In the present study, thiamine diphosphate-dependent enzymes were measured using standard spectrophotometric techniques in homogenates of brain tissue obtained at autopsy from eight alcoholic patients, all of whom died in hepatic coma without clinical or neuropathological evidence of Wernicke's encephalopathy and six nonalcoholic, age-matched controls, matched for autopsy delay time and free, at the time of death, from gross malnutrition or other neurological or psychiatric disorders. " 07/01/1999 - "Recent findings on the effects of alcohol on thiamine absorption and storage and on thiamine phosphorylation to the enzyme co-factor form (thiamine diphosphate) are discussed with regard to the postulated "biochemical lesion" of Wernicke encephalopathy. " 01/01/1995 - "Regional alterations of thiamine phosphate esters and of thiamine diphosphate-dependent enzymes in relation to function in experimental Wernicke's encephalopathy." 11/01/1986 - "We studied a thiamine-dependent enzyme, transketolase, from fibroblasts of a diabetic patient who developed Wernicke's encephalopathy when treated with tolazamide, in order to delineate if this patient also had transketolase abnormality [high Km for thiamine pyrophosphate (TPP)], as previously reported in postalcoholic Wernicke-Korsakoff syndrome. "
7.	EnzymesIBA 03/01/2012 - "Wernicke's encephalopathy is an acute, serious brain disorder resulting from thiamine deficiency, which is important as a cofactor in several enzymes associated with carbohydrate metabolism. " 08/01/1995 - "Reduced activities of thiamine-dependent enzymes in brains of alcoholics in the absence of Wernicke's encephalopathy." 07/01/1989 - "Wernicke encephalopathy is a disorder caused by a deficiency of thiamine which is a cofactor of several metabolic enzymes. " 08/01/1995 - "In the present study, thiamine diphosphate-dependent enzymes were measured using standard spectrophotometric techniques in homogenates of brain tissue obtained at autopsy from eight alcoholic patients, all of whom died in hepatic coma without clinical or neuropathological evidence of Wernicke's encephalopathy and six nonalcoholic, age-matched controls, matched for autopsy delay time and free, at the time of death, from gross malnutrition or other neurological or psychiatric disorders. " 01/01/1995 - "Regional alterations of thiamine phosphate esters and of thiamine diphosphate-dependent enzymes in relation to function in experimental Wernicke's encephalopathy."
8.	Disulfiram (Antabuse)FDA Link 02/01/1958 - "[Subacute encephalopathy occuring during disulfiram therapy; Gayet-Wernicke's disease; trial clinical & pathogenic interpretation]." 06/01/2013 - "We report a rare patient with both Wernicke encephalopathy and disulfiram intoxication. " 06/01/2013 - "There have been several reports of disulfiram intoxication, but little evidence of neurologic conditions resulting from disulfiram-induced brain damage combined with Wernicke encephalopathy-associated lesions. " 06/01/2013 - "A case of Wernicke encephalopathy combined with disulfiram intoxication." 12/01/2006 - "We report the case of a patient with an unusual association of Wernicke encephalopathy and chronic disulfiram intoxication. "
9.	Janus Kinase 2IBA 05/01/2015 - "The aim of the study was to report a case of Wernicke encephalopathy (WE) due to fedratinib (Janus Kinase 2 inhibitor) treatment with atypical neuroimaging findings. " 05/01/2015 - "Putamina involvement in Wernicke encephalopathy induced by Janus Kinase 2 inhibitor." 10/01/2014 - "The Janus kinase 2 inhibitor fedratinib inhibits thiamine uptake: a putative mechanism for the onset of Wernicke's encephalopathy."
10.	Vitamin B Complex (B Vitamins)IBA 01/01/1977 - "A catamnestic study of 50 patients with Wernicke's disease showed that nearly all patients retained residual symptoms and that the prognosis as to life expectancy and social functioning was poor, even after early institution of vitamin B-complex medication. " 03/01/2013 - "Because nutritional factors are implicated, as in Wernicke's encephalopathy, some authors claim that replacement of B vitamins is beneficial. "

Therapies and Procedures

1.	Parenteral Nutrition 12/01/2015 - "[A Case of Wernicke's Encephalopathy Presenting with Acute Deterioration of Consciousness Caused by Peripheral Parenteral Nutrition]." 05/01/2015 - "[Gayet-Wernicke encephalopathy: A rare complication of prolonged parenteral nutrition]." 09/01/2010 - "[Wernicke's encephalopathy following prolonged parenteral nutrition]." 04/01/2010 - "We describe a patient with non-alcoholic Wernicke's encephalopathy caused by long-term parenteral nutrition. " 02/01/2009 - "Wernicke's syndrome during parenteral feeding: not an unusual complication."
2.	Oral Administration 08/01/1976 - "Oral administration of TPD eliminated lateral rectus palsy in patients with Wernicke's encephalopathy. " 06/01/2009 - "The suspected diagnosis was Wernicke's encephalopathy and treatment consisted of intramuscular thiamine shots followed by oral administration of the same drug, which produced rapid symptom resolution. "
3.	Institutionalization (Institutionalized Persons) 01/01/2015 - "Undiagnosed and/or undertreated Wernicke's encephalopathy can result in permanent brain damage, long-term institutionalization, and death. " 04/01/1989 - "Patients were excluded from this study if they had clinical brain (including Wernicke's) disease, died in coma, had liver disease, significant brain atrophy, or dementia severe enough to require institutionalization. " 06/01/1989 - "Patients were excluded from this study if they had clinical brain diseases (including Wernicke's disease), died in coma, or had liver disease, significant brain atrophy, or dementia severe enough to require institutionalization. "
4.	Bone Marrow Transplantation (Transplantation, Bone Marrow) 09/01/1997 - "Iatrogenic Wernicke's encephalopathy in allogeneic bone marrow transplantation: a study of eight cases."
5.	Bariatric Surgery 11/01/2012 - "The number of patients with Wernicke's encephalopathy may increase with bariatric surgery becoming more common. " 03/01/2012 - "Bariatric surgery is listed among the causes of Wernicke's encephalopathy. " 03/01/2012 - "[Wernicke's encephalopathy as a complication of bariatric surgery]." 05/01/2010 - "The alcohol factor in Wernicke's encephalopathy post bariatric surgery." 06/01/2009 - "Peculiarities of wernicke encephalopathy after bariatric surgery."