Abstract

In a nine year necropsy study in Western Australia, the incidence of Wernicke's encephalopathy was 2.8%. The incidence appears to be increasing. Although Wernicke's encephalopathy is a nutritional disorder, the majority of cases occur in the alcoholic population. Only 20% of the 131 cases studied had been diagnosed clinically as Wernicke's encephalopathy. This large discrepancy between numbers of cases diagnosed clinically and pathologically suggests that chronic Wernicke's encephalopathy, which comprised 83% of the cases, may be the end result of repeated subclinical episodes of Wernicke's encephalopathy. Thus, Wernicke's encephalopathy could be considered a "progressive" disorder and as patients respond well to thiamine replacement therapy, early diagnosis is important. Alternatively, prevention by vitamin enrichment of alcoholic beverages may have to be considered in an attempt to minimise the social and economic impact of Wernicke's encephalopathy on Western society.