Table 1.
The operational criteria for the clinical diagnosis of WE, as formulated by Caine et al23
| Symptom or sign | As evidenced by one or more of the following |
|---|---|
| Dietary deficiencies | – Undernutrition (body mass index <2 SD below normal) |
| – A history of grossly impaired dietary intake | |
| – An abnormal thiamine status | |
|
| |
| Oculomotor abnormalities | – Ophthalmoplegia |
| – Nystagmus | |
| – Gaze palsy | |
|
| |
| Cerebellar dysfunction | – Unsteadiness or ataxia |
| – Abnormalities of past pointing | |
| – Dysdiadokokinesia | |
| – Impaired heel-shin testing | |
|
| |
| Either an altered mental state | – Disorientation in two of three fields |
| – Confused | |
| – An abnormal digit span | |
| – Comatose | |
| or | or |
| Mild memory impairment | – Failure to remember two or more words in the four-item memory test |
| – Impairment on more elaborate neuropsychological tests of memory function | |
Notes: When two out of these four criteria apply, the clinical diagnosis of WE is made. The criteria are less sensitive in case of a co-occurring hepatic encephalopathy.
Abbreviation: WE, Wernicke encephalopathy.