How is Wernicke-Korsakoff syndrome (WKS) diagnosed?

Updated: May 16, 2018
  • Author: Glen L Xiong, MD; Chief Editor: David Bienenfeld, MD  more...
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Wernicke encephalopathy should be differentiated from acute delirium secondary to hypoxia, hypercarbia, central nervous system (CNS) infections, and postictal state (seizure). Ataxic disorders also can result from cerebellar infarction. Ocular disorders also can result from vasculitis or infarction.

Several recent review papers have suggested routinely incorporating the Caine criteria, proposed in 1997. Because the classic textbook symptoms are rare and because the potentially treatable disorder is so often missed, these criteria may provide significant value in the general hospital and psychiatric hospital setting. [36]

These criteria suggest that a diagnosis of Wernicke encephalopathy can be made if 2 of the following are present in a patient with chronic alcoholism:

  • Eye signs (ocular abnormalities as described above)

  • Cerebellar signs (ataxia as described above)

  • Mild memory impairment of confusion without another etiology

  • Signs of malnutrition on physical or laboratory exam

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