The contribution of Wernicke's encephalopathy to alcohol-related cerebellar damage

Mid-sagittal histological sections of the cerebellar vermis were prepared for light microscopy from six patients with Wernicke's encephalopathy, 13 alcoholics and 16 normal controls. From Nissl stained sections, the Wernicke's encephalopathy group was found to have a significant 29% lower Purkinje cell count relative to controls, while the alcoholic group had a non-significant 10% lower cell count. The degree of shrinkage of the molecular layer paralleled the degree of Purkinje cell loss. Damage to the medullary layer in the form of shrinkage in Nissl sections and torpedo formation in silver sections did not correlate as well with Purkinje cell loss. Thiamine deficiency would seem to be a significant contributing factor to the neuropathology of cerebellar damage seen in alcoholism. The presence or absence of cirrhosis of the liver was also found to influence the degree of Purkinje cell loss.