Diagnosis and treatment of Wernicke's encephalopathy: A systematic literature review
Cantu-Weinstein A, Branning R, Alamir M, Weleff J, Do M, Nero N, et al.
Published in Gen Hosp Psychiatry, Vol. 87, pp. 48-59
Methodology
Systematic review of Medline, Embase and CENTRAL for human studies of Wernicke's encephalopathy treated with at least 100 mg of intravenous thiamine: 27 studies (20 case reports, 5 retrospective studies, 1 prospective study, 1 randomised trial).
Key Findings
In 18 of 20 case reports (90%), symptoms partly or fully resolved after intravenous thiamine. The seven larger studies covered 688 patients. 500 mg intravenously three times daily was the most common regimen in the case reports (12 of 20).
Conclusions
Intravenous thiamine can relieve the neurological symptoms, cognitive problems and brain imaging changes of Wernicke's encephalopathy, but the evidence base is thin and diagnostic standards are unclear.
Limitations
Mostly case reports and retrospective studies, with a single randomised trial; publication bias is likely and no comparison group of untreated patients exists.
Supplements Studied
IV thiamine can alleviate neurological symptoms, cognitive dysfunction, and brain imaging lesions
Related Health Concerns
Study Details
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