Wernicke’s encephalopathy is a life threatening brain condition that occurs from a lack of thiamine, or vitamin B1. It can be a complication of alcohol use disorder (AUD).

Thiamine is a vitamin that converts glucose into energy for the brain. It is essential for the development, growth, and function of cells.

A person can get thiamine from the food they eat. Foods that contains thiamine include:

  • whole grains
  • pork
  • poultry
  • fish
  • beans
  • enriched cereals and grains

A person can also get thiamine from supplements or multivitamins.

If a person does not have the right level of thiamine in their body, it can cause certain health conditions. Wernicke’s encephalopathy is a serious condition that can occur from thiamine deficiency.

This article will go into detail about Wernicke’s encephalopathy, including its symptoms, causes, and how it can be treated.

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Wernicke’s encephalopathy is a degenerative brain condition that can develop as a result of thiamine deficiency. If a person is deficient in thiamine, it can cause damage to the thalamus and hypothalamus regions of the brain.


The thalamus is responsible for relaying sensory and motor input to the brain. This includes:

  • vision
  • hearing
  • pain
  • temperature
  • movement
  • touch

The thalamus also has a role in cognitive functions, such as concentration and thinking, and mood regulation.


The hypothalamus helps a person’s body maintain a healthy and balanced state. This is a process known as homeostasis.

The hypothalamus helps maintain homeostasis by controlling the systems that regulate bodily functions. This can include:

  • body temperature regulation
  • hunger or thirst cues
  • sexual arousal
  • stress responses
  • growth
  • breast milk production

Damage to the thalamus or hypothalamus caused by Wernicke’s encephalopathy can cause a person to experience serious health complications. Without prompt treatment, Wernicke’s encephalopathy can be fatal.

Wernicke’s encephalopathy can cause a person to experience a variety of symptoms, such as:

  • confusion
  • hypothermia
  • low blood pressure
  • lack of muscle coordination, known as ataxia
  • disorientation
  • rapid, involuntary eye movements
  • double vision
  • drooping upper eyelids
  • paralysis of some eye muscles
  • fatigue
  • lack of attention
  • drowsiness
  • indifference
  • slow, unsteady gait
  • inability to walk or stand without assistance

It can also result in a coma.

Korsakoff’s syndrome

In addition to these symptoms, around 80–90% of people with Wernicke’s encephalopathy also develop Korsakoff’s syndrome. This is known as Wernicke-Korsakoff syndrome.

Korsakoff’s syndrome is a condition that affects a person’s memory. If a person has Korsakoff’s syndrome, they may be unable to form new memories or take in new information.

Korsakoff’s syndrome can also affect a person’s long-term memory. This can result in a person losing random memories, which they may fill in with imaginary scenarios.

Although Wernicke’s encephalopathy and Korsakoff’s syndrome are separate conditions, some scientists believe they are different stages of one disorder.

Wernicke’s encephalopathy occurs as a result of thiamine deficiency.

The most common cause of Wernicke’s encephalopathy is AUD. Low levels of thiamine from AUD may be a result of:

  • reduced thiamine absorption from the intestines
  • a diet low in nutrition
  • reduced storage of thiamine in the liver
  • malnutrition from frequent vomiting

There are also several conditions that can cause a person to have low thiamine levels, such as:

  • malnutrition
  • starvation
  • eating disorders, such as anorexia
  • prolonged or chronic vomiting
  • cancer
  • AIDS
  • stomach or kidney disorders
  • effects of chemotherapy
  • genetics

If a person experiences any signs of Wernicke’s encephalopathy, they should seek immediate medical attention. Without prompt treatment, Wernicke’s encephalopathy can be fatal.

Early treatment may also prevent a person’s Wernicke’s encephalopathy progressing into Korsakoff’s syndrome.

A person should speak with their doctor if they have any symptoms of early stage thiamine deficiency. This may help prevent a person from developing Wernicke’s encephalopathy.

Early symptoms of thiamine deficiency include:

  • weight loss
  • anorexia
  • confusion
  • short-term amnesia
  • muscle weakness
  • a general feeling of discomfort or unease
  • heart issues

Healthcare professionals treat Wernicke’s encephalopathy with an immediate administration of thiamine. A healthcare professional will inject thiamine into a person’s veins.

A person with Wernicke’s encephalopathy may require daily thiamine injections for several months. These injections can help improve changes in mental state, muscle coordination, and vision problems.

A person recovering from Wernicke’s encephalopathy should avoid alcohol. They should also ensure they eat a nutritious and balanced diet.

If a person developed mobility issues from Wernicke’s encephalopathy, they may require physical therapy. However, certain issues with walking may be permanent depending on how severe they are and how quickly a person received treatment.

A healthcare professional uses several methods to diagnose a person with Wernicke’s encephalopathy. They include:

  • Reviewing a person’s health history: A healthcare professional will look at a person’s nutritional and alcohol intake. They may also check whether a person has a history of AUD.
  • Physical examination: A healthcare professional checks the person for physical symptoms of Wernicke’s encephalopathy. They can diagnose the condition if a person has two of the following symptoms:
    • eye signs
    • thiamine deficiency
    • altered mental state
    • irregular motor function
  • Laboratory tests: A healthcare professional may use lab tests to rule out other conditions. This can include blood tests or imaging tests.

If a person is concerned that they may have AUD, they can speak with a doctor.

A person may have AUD if they are unable to stop or reduce alcohol consumption despite health, social, or occupational consequences.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) notes that symptoms of AUD include:

  • wanting to cut down on alcohol consumption but being unable to
  • drinking more alcohol than intended
  • drinking frequently
  • wanting a drink so much that it is impossible to focus on anything else
  • finding that drinking, or being sick from drinking, interferes with work, relationships, or school
  • continuing to drink even though it causes relationship issues
  • reducing other activities that used to be important to drink instead
  • being in unsafe situations while drinking, such as driving or having sex without barrier protection
  • continuing to drink even though it causes feelings of depression or anxiety
  • drinking despite it causing health issues
  • having to drink more alcohol than before to get drunk
  • having withdrawal symptoms once the alcohol effects wear off

There are various resources available for a person experiencing AUD. These include:

  • 12-step programs, which provide peer support and encouragement
  • behavioral treatments, such as counseling
  • certain prescription medications, such as naltrexone and acamprosate

A person may also benefit from speaking with their friends and family about their AUD. Many healthcare professionals believe that having support from loved ones is beneficial for a person overcoming AUD.

There are also various websites that offer support and information for people with AUD, such as:

Wernicke’s encephalopathy is a life threatening degenerative brain condition that occurs due to a thiamine deficiency. It can cause symptoms such as lack of muscle coordination, irregular eye movements, and confusion. Without prompt treatment, it can be fatal.

Over time, a person may develop Korsakoff’s syndrome alongside Wernicke’s encephalopathy. This can result in additional symptoms, such as memory loss.

Although there are various conditions that can cause Wernicke’s encephalopathy, it is mostly the result of AUD.

Once a healthcare professional diagnoses a person with Wernicke’s encephalopathy, they can begin treatment. Treatment involves injections of thiamine as well as abstinence from alcohol.

If a person has any symptoms of Wernicke’s encephalopathy, they should seek immediate medical attention. A person should talk with a doctor if they think they may have AUD.