Attorneys for Failure to Diagnose Wernicke's Encephalopathy in New York City


What is Wernicke’s Encephalopathy?

Wernicke’s Encephalopathy (WE) is caused when a deficiency in B vitamins, particularly Vitamin B1 (Thiamine) causes the development of lesions in the central nervous system. Though the body is capable of creating most of the vitamins and minerals it requires to properly function, B vitamins must be consumed as part of the diet. When they are not, or when certain behaviors, diseases, or procedures cause the rapid depletion of these reserves, a variety of health conditions can occur.

Wernicke’s Encephalopathy is not the only disease caused by a lack of Thiamine. Other related disorders include beriberi and Korsakoff Syndrome. Whenever beriberi or Korsakoff Syndrome are suspected or diagnosed, doctors should be particularly cognizant of potential comorbidity with Wernicke’s Encephalopathy. If diagnosed and treated quickly, usually through Thiamine supplementation, most of the health problems associated with WE can be avoided. But if treatment doesn’t occur until after significant lesions have developed, death or long-term disability can occur.

Symptoms and Diagnosis

The classic diagnostic requirements for WE were based on the presentation of three symptoms:

  • Ophthalmoplegia, a paralysis in the muscles responsible for eye movements
  • Ataxia, a disorder of the nervous system affecting voluntary muscle movements, frequently associated with an odd gait when walking or running
  • Confusion, characterized by unusual behavior, general lack of awareness and understanding of surroundings, or an inability to answer basic questions about time, place, and self

Unfortunately, the focus on these symptoms has led to under-diagnosis of WE, as only approximately ten percent of cases present with all three. And additional research has indicated that a variety of other symptoms indicate the potential presence of Wernicke’s Encephalopathy, including dysphagia, drowsiness, papilledema, hearing loss and literally dozens of others. By simplifying diagnostics to just three symptoms, doctors run the risk of missing the diagnosis, which can be fatal.

Wernicke’s Encephalopathy is easily treated if diagnosed early, as Thiamine supplementation can happen very quickly in a hospital setting. The body readily absorbs the nutrient in most situations, allowing patients to make rapid progress in recovering from the disease.

Risk Factors

Though there is no clear causal effect from any disease to the development of Wernicke’s Encephalopathy, there are a variety of recognized risk factors that increase the likelihood of a person developing WE. Some of these are lifestyle based, some are caused by other diseases, and some are caused by medical treatments and procedures.

The most likely lifestyle-based cause of WE is abuse of alcohol, whether resultant in significant liver damage or not. Alcohol has a disruptive effect on the body’s processing of B vitamins, particularly including Thiamine. Less likely, but still a possible contributing lifestyle factor, is people who are malnourished or eat nutrient-poor diets. If the diet is not sufficient to restore Thiamine at the same or greater rate than the body uses the B vitamin, WE could ultimately occur.

Certain diseases are associated with a higher risk of Wernicke’s Encephalopathy. These include pancreatitis, Crohn’s disease, celiac disease, certain cancers, AIDS, and even diseases that cause prolonged incidence of vomiting or diarrhea. Most of these diseases can interfere with the body’s ability to absorb nutrients, contributing to a Thiamine deficit. If a patient has any of these conditions and displays any symptoms in keeping with WE, doctors should perform proper diagnostic tests.

Sometimes, medical procedures can contribute to or even cause the development of Wernicke’s Encephalopathy. Any surgery that interrupts a patient’s ability to eat and drink has a risk of contributing to WE, particularly if the patient requires tube feeding. Some surgeries, particularly Bariatric surgery, can cause damage to the parts of the body that are responsible for nutrient absorption.

To make a proper diagnosis, a physician must evaluate the entire case history of the patient, including existing conditions and concerns. Asking the right questions is a big part of the job. Recognizing symptoms is important, as is recognizing which symptoms are caused by the underlying disease and which might have nothing to do with the pathology at hand.

When dealing with a disease like Wernicke’s Encephalopathy, thoroughly vetting the case history is even more important, as certain diseases and procedures drastically increase the likelihood that WE is the cause of certain symptoms. Branching out from the trio of symptoms most commonly associated with the disease is also important, as too many patients have suffered too many missed diagnoses due to medical stubbornness.

If you or a loved one has suffered due to a missed diagnosis of Wernicke’s Encephalopathy, or if a medical procedure contributed to development of the disease, it is extremely important that the case be properly evaluated to determine what should have been done differently by the medical team. Finz & Finz, P.C., has a long history of building strong cases when malpractice occurs. Contact Finz & Finz, P.C., now, toll free, at (855) TOP FIRM, or fill out the Free Wernicke’s Encephalopathy Evaluation Form to have a qualified expert evaluate your case.