Abstract
During a four year peirod, 51 cases of Wernicke's encephalopathy were diagnosed at necropsy, an incidence of 1.7% of all necropsies performed at the Royal Perth Hospital and by the Perth City coroner. Only seven had been diagnosed during life. Many of the patients died suddenly and unexpectedly, apparently as a result of haemorrhagic brainstem lesions, typical of acute Wernicke's encephalopathy, since no other cause of death was found. There was a high incidence of epilepsy and four patients were hypothermic. The diagnosis of Wernicke's encephalopathy may be missed at necropsy unless the brain is examined histologically. Cerebral atrophy and ventricular dilatation were common findings. This is a more common disease than is generally recognised, one which can be readily treated and, more importantly, prevented by adequate nutrition.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ackerman W. J. Stupor, bradycardia, hypotension and hypothermia. A presentation of Wernicke's encephalopathy with rapid response to thiamine. West J Med. 1974 Nov;121(5):428–429. [PMC free article] [PubMed] [Google Scholar]
- BRIN M. Erythrocyte transketolase in early thiamine deficiency. Ann N Y Acad Sci. 1962 Apr 26;98:528–541. doi: 10.1111/j.1749-6632.1962.tb30574.x. [DOI] [PubMed] [Google Scholar]
- Brewer C., Perrett L. Brain damage due to alcohol consumption: an air-encephalographic, psychometric and electroencephalographic study. Br J Addict Alcohol Other Drugs. 1971 Nov;66(3):170–182. doi: 10.1111/j.1360-0443.1971.tb02382.x. [DOI] [PubMed] [Google Scholar]
- CRAVIOTO H., KOREIN J., SILBERMAN J. Wernicke's encephalopathy. A clinical and pathological study of 28 autopsied cases. Arch Neurol. 1961 May;4:510–519. doi: 10.1001/archneur.1961.00450110040005. [DOI] [PubMed] [Google Scholar]
- Cala L. A., Jones B., Mastaglia F. L., Wiley B. Brain atrophy and intellectual impairment in heavy drinkers--a clinical, psychometric and computerized tomography study. Aust N Z J Med. 1978 Apr;8(2):147–153. doi: 10.1111/j.1445-5994.1978.tb04502.x. [DOI] [PubMed] [Google Scholar]
- DREYFUS P. M. Clinical application of blood transketolase determinations. N Engl J Med. 1962 Sep 20;267:596–598. doi: 10.1056/NEJM196209202671204. [DOI] [PubMed] [Google Scholar]
- Derrick E. H. A survey of the mortality caused by alcohol. Med J Aust. 1967 Nov 11;2(20):914–919. doi: 10.5694/j.1326-5377.1967.tb74359.x. [DOI] [PubMed] [Google Scholar]
- Fox J. H., Ramsey R. G., Huckman M. S., Proske A. E. Cerebral ventricular enlargement. Chronic alcoholics examined by computerized tomography. JAMA. 1976 Jul 26;236(4):365–368. doi: 10.1001/jama.236.4.365. [DOI] [PubMed] [Google Scholar]
- KAYE S., HAAG H. B. Terminal blood alcohol concentrations in ninety-four fatal cases of acute alcoholism. J Am Med Assoc. 1957 Oct 5;165(5):451–452. doi: 10.1001/jama.1957.72980230001006. [DOI] [PubMed] [Google Scholar]
- Laurie W. Alcohol as a cause of sudden unexpected death. Med J Aust. 1971 Jun 5;1(23):1224–1227. doi: 10.5694/j.1326-5377.1971.tb50306.x. [DOI] [PubMed] [Google Scholar]
- PHILLIPS G. B., VICTOR M., ADAMS R. D., DAVIDSON C. S. A study of the nutritional defect in Wernicke's syndrome; the effect of a purified diet, thiamine, and other vitamins on the clinical manifestations. J Clin Invest. 1952 Oct;31(10):859–871. doi: 10.1172/JCI102673. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ron M. A. Brain damage in chronic alcoholism: a neuropathological, neuroradiological and psychological review. Psychol Med. 1977 Feb;7(1):103–112. doi: 10.1017/s0033291700023187. [DOI] [PubMed] [Google Scholar]
- TAVEL M. E., DAVIDSON W., BATTERTON T. D. A critical analysis of mortality associated with delirium tremens. Review of 39 fatalities in a 9-year period. Am J Med Sci. 1961 Jul;242:18–29. doi: 10.1097/00000441-196107000-00003. [DOI] [PubMed] [Google Scholar]
- Wilkinson P., Kornaczewski A., Rankin J. G., Santamaria J. N. Physical disease in alcoholism. Initial survey of 1,000 patients. Med J Aust. 1971 Jun 5;1(23):1217–1223. [PubMed] [Google Scholar]