Caine Criteria (Wernicke Encephalopathy)
Flags possible Wernicke encephalopathy when TWO of four signs are present (Caine 1997): dietary deficiency, oculomotor abnormalities, cerebellar dysfunction, and either an altered mental state or mild memory impairment.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Dietary deficiency
- Yes
- Altered mental state or memory
- Yes
Result: Caine criteria met - 2 of 4 signs present. Consider Wernicke encephalopathy and give thiamine.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Signs
- Dietary deficiency; oculomotor abnormalities; cerebellar dysfunction; an altered mental state OR mild memory impairment. Two of the four are enough.
- Why two
- The classic triad appears in only about 16% of cases and about 19% show none of it at first assessment. At two signs the criteria are about 85% sensitive.
- Caution
- Not meeting two does NOT exclude the diagnosis. Thiamine is given on suspicion and is safe, so nothing here is a reason to withhold it.
What you enter
- Dietary deficiency
- Oculomotor abnormalities
- Cerebellar dysfunction
- Altered mental state or memory
How this is calculated
Caine D, Halliday GM, Kril JJ, Harper CG. Operational criteria for the classification of chronic alcoholics: identification of Wernicke encephalopathy. J Neurol Neurosurg Psychiatry. 1997;62(1):51-60. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.