[Wernicke's encephalopathy in patients with alcohol withdrawal symptoms].

INTRODUCTION

Wernicke's encephalopathy (WE) is caused by lack of thiamin. In Denmark, WE most often occurs in alcoholics. In the present study, we wanted to investigate the frequency of WE in patients hospitalized for treatment of alcohol withdrawal symptoms in a psychiatric emergency ward.

MATERIAL AND

METHODS

Prospective registration of symptoms and treatment regimen in all patients admitted for alcohol withdrawal treatment in the period 22.02.2007-31.08.2008.

RESULTS

Symptoms of WE occurred in 52 of a total of 497 patients (11%). Ataxia of gait was the predominant symptom, succeeded by cognitive impairment, whereas ocular palsy was unusual. Patients with WE were on average administered approximately 50% more phenobarbital than patients without symptoms of WE (p < 0.01), probably reflecting a more severe withdrawal reaction. In 21 of the 52 patients with WE (41%) the preceding period of alcohol intake was shorter than 14 days.

DISCUSSION: WE is a frequently occurring condition among patients treated for alcohol withdrawal symptoms in psychiatric wards. A possible pathogenetic factor is the alcohol withdrawal reaction, as cerebral hyperactivity may lead to increased thiamin consumption and thus depletion of the depots. To avoid insufficient treatment, routine administration of large doses of intravenous thiamine to all patients admitted with alcohol withdrawal symptoms should be considered.