special subjects
Wernicke Encephalopathy
Diagnosis of Wernicke Encephalopathy
Usually a clinical diagnosis There are no specific diagnostic studies. Diagnosis of Wernicke encephalopathy is clinical and depends on recognition of underlying undernutrition or vitamin deficiency in a patient with typical signs and symptoms. There are no characteristic abnormalities in cerebrospinal fluid, evoked potentials, brain imaging, or electroencephalogram. However, these tests, as well as laboratory tests (eg, blood tests, glucose, complete blood count, liver tests, arterial blood gas measurements, toxicology screening), should typically be done to rule out other etiologies. Thiamin levels are not routinely measured, because serum thiamin levels do not always reflect cerebrospinal fluid levels and normal serum levels do not exclude the diagnosis. 