Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
Department of Clinical Biochemistry, North West Anglia NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK.
Ann Clin Biochem. 2021 Jan;58(1):38-46. doi: 10.1177/0004563220939604. Epub 2020 Jul 13.
Wernicke's encephalopathy is caused by thiamine deficiency and has a range of presenting features, including gait disturbance, altered cognitive state, nystagmus and other eye movement disorders. In the past, Wernicke's encephalopathy was described almost exclusively in the alcohol-dependent population. However, in current times, Wernicke's encephalopathy is also well recognized in many other patient groups, including patients following bariatric surgery, gastrointestinal surgery, cancer and pancreatitis. Early recognition of Wernicke's encephalopathy is vital, as prompt treatment can restore cognitive or ocular function and can prevent permanent disability. Unfortunately, Wernicke's encephalopathy is often undiagnosed - presumably because it is relatively uncommon and has a variable clinical presentation. Clinical biochemists have a unique role in advising clinicians about potential nutritional or metabolic causes of unexplained neurological symptoms and to prompt consideration of thiamine deficiency as a potential cause in high-risk patient groups. The aim of this review is to summarize the clinical features, diagnosis and treatment of Wernicke's encephalopathy and to highlight some non-traditional causes, such as after bariatric surgery.
韦尼克脑病是由硫胺素缺乏引起的，其表现特征多种多样，包括步态障碍、认知状态改变、眼球震颤和其他眼球运动障碍。过去，韦尼克脑病几乎仅在酒精依赖人群中描述。然而，在当今时代，韦尼克脑病也在许多其他患者群体中得到了很好的认识，包括接受减肥手术、胃肠道手术、癌症和胰腺炎的患者。早期识别韦尼克脑病至关重要，因为及时治疗可以恢复认知或眼部功能，并可防止永久性残疾。不幸的是，韦尼克脑病常常未被诊断——大概是因为它相对少见，且临床表现多变。临床生化医师在向临床医生提供有关不明原因神经系统症状的潜在营养或代谢原因方面具有独特的作用，并促使他们考虑硫胺素缺乏作为高危患者群体的潜在原因。本综述的目的是总结韦尼克脑病的临床特征、诊断和治疗，并强调一些非传统原因，例如减肥手术后。
