Diagnosis and treatment of Wernicke's encephalopathy in an in-patient alcohol detoxification unit: a completed audit cycle

Abstract

Aims and methodA baseline audit of trainees' ability to recognise Wernicke's encephalopathy and initiate appropriate thiamine regimes in an in-patient alcohol detoxification unit was carried out. Based on the findings, gaps were addressed using targeted education and training, and their impact on improving standards of managing Wernicke's encephalopathy was re-audited.ResultsThe initial audit revealed that trainees' ability to recognise Wernicke's encephalopathy and initiate thiamine was inadequate. Significant improvement in appropriate use of treatment regime (P < 0.05) of thiamine and the monitoring of clinical response was observed after addressing the initial gaps through education.Clinical implicationsTreatment of Wernicke's encephalopathy can be inadequate, given a lack of awareness of clinical presentation and appropriate management. This can be addressed through education and training.

Brain Trauma and the Secondary Cascade in Humans: Review of the Potential Role of Vitamins in Reparative Processes and Functional Outcome

“…Evidence for the damaging neurological consequences of thiamine deficiency comes from studies of chronic alcohol use and Wernicke-Korsakoff syndrome [96]. Wernicke's encephalopathy is initially characterized by eye movement and gait disturbances, widespread peripheral nerve damage and cognitive impairments [92,97]. A high-dose thiamine supplement is used as a treatment, although recovery may only be partial, particularly regarding cognitive deficits.…”