Criteria of Caine et al for Wernicke's Encephalopathy in a Chronic Alcoholic

 

Patient selection: chronic alcoholic (population with an increased pre-test probability)

 

Criteria for Wernicke's encephalopathy - 2 or more of the following:

(1) dietary deficiencies (malnutrition, undernutrition, vitamin deficiencies, etc)

(2) oculomotor abnormalities (gaze palsy, nystagmus, ophthalmoplegia)

(3) cerebellar dysfunction (ataxia, unsteady gait, abnormal past pointing, etc)

(4) one or both of the following:

(4a) altered mental status (disoriented, confused, stupor or coma)

(4b) mild memory impairment

 

The presence of hepatic encephalopathy may make the diagnosis of Wernicke's encephalopathy more difficult and easier to miss.