Wernicke syndrome i (superior hemorrhagic polioencephalopathic syndrome; hemorrhagic polioencephalitis superior syndrome; encephalitis hemorrhagica superioris; avitaminosis b; thiamine deficiency; beriberi; gayet-wernicke syndrome; wernicke-korsakoff syndrome) 1

General: Lack of vitamin B or thiamine; focal vascular lesions in the gray matter around third and fourth ventricles and sylvian aqueduct; alcoholics (adults); beriberi of all ages.

Ocular: Ptosis; acute bilateral nuclear ophthalmoplegia; complete ophthalmoplegia; retinal hemorrhages; optic atrophy; optic neuritis; conjunctivitis; blepharitis; nutritional amblyopia; central scotoma; papilledema; nystagmus; absolute pupillary paralysis or Argyll Robertson pupils; accommodative palsy.

Clinical: Early prostration; lethargy; irritability; stupor; delirium; mental disturbances to Korsakoff psychosis; ataxia; tremors; peripheral neuritis; anorexia; vomiting; insomnia; perspiration; tachycardia; hallucinations; retrograde amnesia; apathy; anxiety; fear; defective concentration; cardiomyopathy.

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Shimojyo S, et al. Cerebral blood flow and metabolism in the Wernicke-Korsakoff syndrome. J Clin Invest 1967; 46:849.

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Yuen TS, Simon RP. Wernicke's encephalopathy. In: Bradley WG, et al., eds. Neurology in Clinical practice, 2nd ed. Boston: Butterworth-Heinemann, 1995:1382-l383.