Atypical Wernicke’s Encephalopathy under-recognized in clinical settings

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Legally reviewed by:
Steven R. Davis and John A. Davis, Jr.
August 4, 2023

Wernicke’s encephalopathy (WE) is typically associated with emergency department patients who abuse alcohol. Early diagnosis and treatment are essential, as WE can be fatal if mis-diagnosed or not treated. The symptoms of WE can include lack of muscle control, paralysis of muscles around the eye, and altered mental state. While, WE can be the result of chronic alcohol abuse, there are other high-risk conditions that are increasingly connected with WE, including severe nausea and weight loss, gastric bypass surgery, and AIDS. According to autopsy data, WE is significantly under-recognized in Texas and throughout the United States. It’s important to recognize non-typical presentations of WE because treatment can prevent severe adverse effects like coma and permanent mental impairment.
A 63-year-old woman came to the emergency department with double vision, headache, and an unsteady gait. Her appetite had also decreased due to her symptoms. The patient and her family reported no history of alcohol use. Her recent medical history included pneumonia, for which she was on day five of a ten-day antibiotic regimen.
While WE is associated with chronic alcohol abuse, any patient with a nutritional deficiency can develop the condition. One retrospective study found that 23% of WE cases were not connected with alcoholism.
Changes in mental status are one of the most common symptoms associated with WE, occurring in 80-90% of cases. Mental status changes can include memory issues, reduced concentration, apathy, delirium, and coma. The many factors that contribute to WE make it a difficult condition to diagnose.
When a serious condition, like WE, is misdiagnosed or missed altogether, the results can be severe. In the case of Wernicke’s encephalopathy, a missed diagnosis can result in coma or death. Family members who have experienced a loss due to a missed diagnosis or misdiagnosis can explore their legal options with a qualified medical malpractice attorney. An attorney with a background in medical malpractice will understand the intricacies of a complex medical case.

John A. Davis, Jr.


John A. Davis, Jr. and Steven R. Davis

August 4 2023

Steven R. Davis and John A. Davis, Jr. are experienced attorneys at Davis & Davis, a law firm that specializes in medical malpractice cases in Texas. With a deep commitment to justice that guides their ethical approach, Davis and Davis have dedicated their careers to helping victims of medical negligence. They and their team continue to advocate for clients, despite the challenges posed by Texas's cap on recoverable damages in malpractice lawsuits. Davis & Davis pride themselves on their extensive experience in the field and their readiness to meet clients across the United States.

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