Wernicke's encephalopathy is a consistent and readily recognized clinical syndrome, the central feature of which is an acute ocular disturbance. This disturbance takes the form of horizontal and vertical nystagmus and various degrees of paralysis of conjugate gaze and of the external recti muscles. In nearly all cases there are also mental symptoms and ataxia, the latter symptom mainly affecting the patient's stance and gait. In the acute stage of the illness the dominant mental manifestations are a general lack of interest and of attentiveness, together with apathy and occasionally drowsiness. Spontaneous speech is minimal, but disorientation is easily demonstrated. In some instances it is obvious at the outset that the patient has a dementia that is ordinarily regarded as Korsakoff's psychosis, that is, one which comprises impairment of recent memory and inability to retain and recall newly presented material. Usually, however, the features of the Korsakoff psychosis become
VICTOR M, ALTSCHULE MD, HOLLIDAY PD, GONCZ R, COUNTY A. Carbohydrate Metabolism in Brain Disease: VIII. Carbohydrate Metabolism in Wernicke's Encephalopathy Associated with Alcoholism. AMA Arch Intern Med. 1957;99(1):28–39. doi:10.1001/archinte.1957.00260010030005
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