PRESENTATION OF ACUTE WERNICKES ENCEPHALOPATHY AND TREATMENT WITH THIAMINE

Thirty two cases of acute Wernicke's encephalopathy were observed in a period of 33 months, and prior to the mandatory thiamine enrichment o f Australian bread-making flour in 1991. These cases were carefully as sessed by multiple tests at specified intervals prior to, and followin g thiamine administration until discharge from hospital. Structured sc oring of neurological signs and symptoms, CT scans, psychometry, nutri tional measurements, and liver biopsies were performed. There was vari ation in the presentation and severity of clinical signs and symptoms and in response to treatment. All patients had alcohol-related liver d isease, and the results indicated that fatty liver was important in pr esentation and in response to treatment with thiamine. Other forms of alcohol related brain damage were present in these patients, most of w hom were in the 4th or 5th decade of life and had been drinking beer t o excess for more than 20 years.