Wernicke's Encephalopathy: A brain injury caused by vitamin deficiency

07 June 2024

Wernicke’s encephalopathy is a rare brain injury caused by reduced thiamine intake which is often missed or misdiagnosed. Without simple treatment this can cause permanent brain damage, disability, or death.

June is Alzheimer’s and brain injury awareness month and we’re highlighting a serious brain injury caused by vitamin B1 (thiamine) deficiency Wernicke’s encephalopathy (WE). If untreated, can cause Korsakoff’s syndrome, a permanent form of dementia causing memory and neurological problems. WE can also lead to coma and death in severe cases.

Signs and symptoms

WE can cause a range of symptoms, such as confusion, memory loss, eye problems, poor coordination, and impaired consciousness. It is less common than other types of brain injury. This, along with the broad range of symptoms means it is often misdiagnosed as encephalitis, stroke, infection or other neurological condition.

Who does it affect?

WE can affect anybody. It is often seen in people with chronic alcoholism, as alcohol interferes with thiamine uptake and use. However, there are many other reasons why people might have low thiamine, including poor nutrition, vomiting, stomach/bowel surgery or conditions, weight loss surgery, cancer, HIV or eating disorders. These people may not have the typical signs of alcoholism, like liver problems that would alert the doctors to thiamine deficiency. So, many people with WE are not identified or treated properly, and as a result they may suffer from permanent brain damage or death.

How is it treated?

The treatment for WE is simple and effective, if given early enough. It simply involves thiamine injections and tablets to replace the thiamine deficiency in the body. Thiamine injections can quickly restore the normal levels of thiamine in the body and prevent brain damage. However, some of the neurological symptoms may not be reversible, especially if the condition is diagnosed late or left untreated. Therefore, it is crucial to recognize the signs of WE and start treatment as soon as possible.

The tragedy of WE is that it is entirely preventable and treatable if diagnosed early. Delay in diagnosis can result in irreversible brain damage and disability that could have been avoided with proper care. Therefore, it is crucial to raise awareness and improve diagnosis of WE among both medical professionals and the public.

Can medical negligence contribute to WE?

Our specialist medical negligence solicitors at Shoosmiths have considerable experience in brain injuries caused by Wernicke’s encephalopathy, and Korsakoff’s syndrome. Possible examples of medical negligence include:

  • Failure to recognise the signs and symptoms of WE.
  • Misdiagnosing WE as an alternative brain injury or neurological condition.
  • Failure to administer thiamine quickly enough, or in sufficient doses.
  • Failure to monitor the response to thiamine treatment and adjust the dosage or route of administration as needed.
  • Failure to educate the patient and their family about the importance of thiamine supplementation and dietary changes to prevent recurrence of WE.

Any of these errors can have devastating consequences for the patient, who may suffer permanent but avoidable brain damage, cognitive impairment, or even death.

Natasha Read, Partner and medical negligence specialist solicitor at Shoosmiths comments:

‘My client, Laura* was misdiagnosed with encephalitis in hospital. Fortunately, due to our expertise, our many years’ experience in medical negligence and the strength of our team, my colleagues and I were able to prove that she in fact had suffered from WE, a condition which even her treating doctors did not consider. Sadly, Laura has now sustained a devastating and permanent brain injury caused by Korsakoff’s syndrome because of a simple failure to give her thiamine supplementation. She is now unable to live independently, is unable to work and will require care and assistance for the rest of her life. In Laura’s case, the Defendant hospital has admitted negligence, and we are in the process of obtaining compensation to assist Laura with the rehabilitation, treatment and assistance she desperately needs.’

*name has been altered to preserve anonymity.



This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2024

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