Hepatic Encephalopathy

Wernicke Encephalopathy (WE)

Classic Triad (in only ~10%):

1. Encephalopathy
2. Ataxic gait, and
3. Some variant of oculomotor dysfunction

Ocular abnormalities are the hallmarks of WE - nystagmus (most common), bilateral lateral rectus palsies, and conjugate gaze palsies reflecting cranial nerve involvement of the oculomotor, abducens, and vestibular nuclei.