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Related Experiment Videos

Distinctive acid-base pattern in Wernicke's encephalopathy.

Michael W Donnino1, Joseph Miller, A Joseph Garcia

  • 1Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. mdonnino@bidmc.harvard.edu

Annals of Emergency Medicine
|December 6, 2006
PubMed
Summary
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Unrecognized Wernicke

Area of Science:

  • Neurology
  • Internal Medicine
  • Critical Care Medicine

Background:

  • Wernicke's encephalopathy (WE) is a serious neurological condition often linked to thiamine deficiency.
  • Early recognition of WE is crucial to prevent severe morbidity and mortality.
  • The typical presentation of WE can be subtle, complicating diagnosis.

Observation:

  • This case series analyzed arterial blood gas (ABG) measurements in patients with diagnosed Wernicke's encephalopathy.
  • Four patients with confirmed WE and available ABG data were included.
  • A consistent, distinctive acid-base disturbance was noted in all analyzed cases.

Findings:

  • All four patients presented with a primary anion-gap metabolic acidosis.
  • This metabolic acidosis was concurrently accompanied by a primary respiratory alkalosis.

Related Experiment Videos

  • Three patients also exhibited significant lactic acidosis, without other identifiable causes.

    • Implications:

    • The observed acid-base pattern (metabolic acidosis + respiratory alkalosis) may serve as a diagnostic clue for WE.
    • Clinicians should consider thiamine deficiency disorders when encountering this specific ABG disturbance.
    • Prompt recognition and treatment of WE can significantly improve patient outcomes.