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J Hosp Med 2022 Jun 21. Epub 2022 Jun 21.

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.

Background: The paucity of research linking thiamine treatment with improved outcomes may be driving its underutilization among patients at risk for Wernicke encephalopathy.

Objective: To assess relationships of thiamine usage to outcomes of patients hospitalized with alcohol use disorder and pneumonia. DESIGN, SETTING AND PARTICIPANTS: This is a retrospective cohort study of adult patients hospitalized with pneumonia who also have alcohol use disorder and were treated with benzodiazepines during the initial two hospital days, between 2010 and 2015 at hospitals participating in the Premier Healthcare Database. Read More

Cureus 2022 May 3;14(5):e24692. Epub 2022 May 3.

Internal Medicine, Hospital de Santo Antionio dos Capuchos, Centro Hospitalar Universitario de Lisboa Central (CHULC), Lisbon, PRT.

A 30-year-old Turkish male was found lethargic and surrounded by vomit. At the hospital, severe hypernatremic dehydration and acute kidney failure were evident. His conscious level improved with fluid resuscitation. Read More

Medicina (Kaunas) 2022 May 13;58(5). Epub 2022 May 13.

Neurology & Neurophysiology Center, Postfach 20, 1180 Vienna, Austria.

Objectives: a stroke-like lesion, the morphological equivalent of a stroke-like episode and the hallmark of mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome, have not been reported as manifestations of thiamine deficiency.

Case Report: a 62-year-old man with a history of chronic alcoholism was admitted after a series of epileptic seizures. Upon waking up from the coma, he presented with disorientation, confusion, confabulation, psychomotor agitation, aggressiveness, right hemianopsia, aphasia, and right hemineglect over weeks. Read More

Prim Care Companion CNS Disord 2022 May 17;24(3). Epub 2022 May 17.

Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, Virginia.

Radiol Case Rep 2022 Jul 7;17(7):2424-2427. Epub 2022 May 7.

Department of Neurology, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.

A 30-year-old woman suffering from an eating disorder and alcoholism presented with a progressively worsening gait disturbance lasting 2 weeks. Her neurological findings included impaired ocular motility and trunk ataxia. Fluid-attenuated inversion recovery imaging of the brain showed hyperintensity in the dorsal brainstem, aqueduct, thalamus, and cerebral cortex. Read More

Intern Med 2022 May 21. Epub 2022 May 21.

Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan.

A 30-year-old man admitted with renal dysfunction (serum creatinine, 8.19 mg/dL) was diagnosed with immunoglobulin A nephritis through a renal biopsy. He was treated with intravenous methylprednisolone pulse therapy and urgent hemodialysis, and eventually, he underwent maintenance hemodialysis. Read More

BMC Neurol 2022 May 16;22(1):181. Epub 2022 May 16.

Department of Neurology, Nagano Red Cross Hospital, 5-22-1, Wakasato, Nagano, 380-8582, Japan.

Background: Bromine compounds are used in several drugs, including over-the-counter drugs. They sometimes cause intoxication known as bromism. Although the acute neurological symptoms and sequelae of bromism vary, few reports have mentioned acute encephalopathy. Read More

Saudi J Kidney Dis Transpl 2021 Sep-Oct;32(5):1456-1460

Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Metabolic encephalopathies are a common cause of altered mental status in various states of malnutrition. However, a high index of suspicion is required to recognize them and differentiate Metabolic Disorders from other causes of altered mental status such as infections. A 6-year old with steroid-resistant nephrotic syndrome (NS), peritonitis, and prolonged diarrhea and vomiting, developed a brief episode of altered mental status six days after starting tacrolimus. Read More

Case Rep Neurol 2022 Jan-Apr;14(1):179-184. Epub 2022 Mar 29.

University of Pittsburgh Medical Center Mercy, Pittsburgh, Pennsylvania, USA.

Bariatric surgery is used as a treatment for morbid obesity and often results in rapid weight loss. This procedure has been associated with postoperative nutritional deficiencies. Neurological complications due to nutritional deficiencies include Wernicke encephalopathy, a disorder that affects the central and peripheral nervous system due to thiamine (vitamin B1) deficiency. Read More

Inflamm Bowel Dis 2022 05;28(5):e70-e71

Gastroenterology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy.

J Gen Fam Med 2022 May 3;23(3):180-182. Epub 2022 Feb 3.

Department of Psycho-oncology Saitama Medical University International Medical Center Hidaka City Saitama Japan.

The patient was an 83-year-old male who, after being hospitalized for 70 days for suffocation due to aspiration, was provided with home medical care (HMC) as his physical condition did not allow him to climb stairs. Wernicke encephalopathy (WE) was suspected based on his disorientation and a continued loss of appetite. This diagnosis was supported by abnormal serum thiamine and the disappearance of delirium after thiamine administration. Read More

Cogn Neuropsychiatry 2022 Jul 28;27(4):296-313. Epub 2022 Apr 28.

King's College London, Institute of Psychiatry, Psychology, and Neuroscience, Surrey, UK.

Introduction: Alwyn Lishman was interested in how memory research could be applied to clinical psychiatry. After a brief review of his major contributions, this paper will focus on his research on the alcoholic Korsakoff syndrome. It will consider how his findings relate to contemporary debates, particularly on how the syndrome should be defined, and its relationship to broader alcohol-induced cognitive impairments. Read More

Neurocase 2022 Apr 24;28(2):185-187. Epub 2022 Apr 24.

Department of Neurology, Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey.

A 22-year-old woman was admitted to the emergency department with headache, dizziness, and numbness on the left side of the body. Neurologic examination revealed gaze-evoked nystagmus. Cranial magnetic resonance imaging, venous and arterial magnetic resonance angiography were normal. Read More

WMJ 2022 Apr;121(1):E10-E14

Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.

Introduction: Providing glucose before thiamine can cause or exacerbate Wernicke encephalopathy, a potentially life-threatening condition associated with a variety of neurological impairments.

Case Presentation: An emaciated, middle-aged woman with a longstanding history of alcohol abuse and an undifferentiated seizure disorder presented to a local emergency department with altered mental status of unknown duration. Initial labs showed signs of acute kidney injury and she could not tolerate oral intake. Read More

Alcohol Clin Exp Res 2022 Jun 10;46(6):1133-1147. Epub 2022 May 10.

Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.

Background: The primary cause of Wernicke-Korsakoff syndrome (WKS) is thiamine deficiency, and more than 90% of cases are reported in alcohol-dependent patients. While observational studies show parenteral thiamine administration drastically reduced WKS-related mortality, relevant treatment trials have never been conducted to determine the optimum thiamine dose.

Methods: Two double-blind, parallel groups, randomized controlled trials (RCTs) were conducted to determine the optimal thiamine dose required for (1) the prevention of Wernicke's encephalopathy (WE), the acute phase of WKS, in asymptomatic but "at-risk" alcohol misuse patients (Study 1) and (2) the treatment of WE in symptomatic alcohol misuse patients (Study 2). Read More

J Neuroophthalmol 2022 Mar 23. Epub 2022 Mar 23.

Department of Ophthalmology (KMN, OEA, ASA), Hennepin Healthcare, Minneapolis, Minnesota; Department of Ophthalmology and Visual Neurosciences (OEA, ASA), University of Minnesota, Minneapolis, Minnesota; and Minnesota Eye Consultants (CAL), Bloomington, Minnesota.

Clin Case Rep 2022 Mar 17;10(3):e05615. Epub 2022 Mar 17.

Department of General Internal Medicine Kobe City Medical Center General Hospital Hyogo Japan.

Wernicke encephalopathy is caused by vitamin B1 deficiency. It presents as a triad consisting of altered mental status, oculomotor dysfunction, and gait ataxia. Early vitamin B1 administration alleviates symptoms. Read More

BMJ Case Rep 2022 Mar 23;15(3). Epub 2022 Mar 23.

Internal Medicine, Sinai Grace Hospital, Detroit, Michigan, USA.

We report a case of Wernicke encephalopathy (WE) in a woman in her 20s who had Roux-en-Y gastric bypass surgery for severe obesity, which resulted in a severe depletion of the patient's thiamine reserve and development of WE syndrome, we also emphasise the importance of prompt diagnosis of this serious complication in addition to the importance of adequate therapy. Read More

J Pak Med Assoc 2022 Mar;72(3):550-553

Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan.

Wernicke's encephalopathy (WE) is an acute neurological condition characterized by a triad of ophthalmoplegia, ataxia and altered mental status. The underlying cause is thiamine deficiency, which may be due to multiple aetiologies. Thiamine is essential for carbohydrate and amino acid metabolism. Read More

Clin Case Rep 2022 Mar 3;10(3):e05539. Epub 2022 Mar 3.

Department of Nephrology Shinshu University School of Medicine Matsumoto Japan.

A 93-year-old hemodialysis patient became hospitalized for thiamine deficiency-induced appetite loss and ultimately experienced consciousness disorder diagnosed as Wernicke's encephalopathy (WE). Since brain MRI on admission was retrospectively found to display faint WE findings, careful brain MRI assessment is recommended in hemodialysis patients with appetite loss alone. Read More

J Gen Fam Med 2022 Mar 12;23(2):104-106. Epub 2021 Sep 12.

Department of Psycho-oncology Saitama Medical University International Medical Center Hidaka City Japan.

A 63-year-old woman had started caring for her mother with dementia 6 months previously. A loss of appetite had appeared 2 months prior to her visit. Neurologically, she experienced mild unsteadiness, but she was fully conscious and had no ocular symptoms. Read More

Asian J Surg 2022 06 26;45(6):1341-1342. Epub 2022 Feb 26.

Department of Anorectal Surgery, The Third Affiliated Hospital of Anhui Medical University, Hefei First People's Hospital, Hefei, 230000, China. Electronic address:

Zhonghua Xue Ye Xue Za Zhi 2022 Jan;43(1):81

Department of Hematology, Beijing Luhe hospital, Capital Medical University, Beijing 101149, China.

Neurocase 2022 02 27;28(1):48-62. Epub 2022 Feb 27.

Utrecht University, Experimental Psychology, Helmholtz Institute, Utrecht, The Netherlands.

Korsakoff's syndrome (KS) is a neurocognitive disorder caused by severe malnutrition. KS patients typically show severe impairments in prospective memory (PM), thus, have difficulties with remembering to perform delayed intentions. The current study investigated the possible benefits of a smartwatch aid for PM tasks in patients with KS and compared its efficacy with verbal in-person reminders. Read More

Biomedicines 2022 Jan 25;10(2). Epub 2022 Jan 25.

Department of Psychobiology and Methods in Behavioral Sciences, Faculty of Psychology, Complutense University of Madrid (UCM), 28223 Madrid, Spain.

Wernicke-Korsakoff syndrome (WKS) is induced by thiamine deficiency (TD) and mainly related to alcohol consumption. Frontal cortex dysfunction has been associated with impulsivity and disinhibition in WKS patients. The pathophysiology involves oxidative stress, excitotoxicity and inflammatory responses leading to neuronal death, but the relative contributions of each factor (alcohol and TD, either isolated or in interaction) to these phenomena are still poorly understood. Read More

Cureus 2022 Jan 19;14(1):e21417. Epub 2022 Jan 19.

Child Neurology and Neurodevelopmental Disabilities, West Virginia University Medicine, Morgantown, USA.

Beriberi neuropathy (thiamine deficiency) and Guillian-Barre Syndrome (GBS) both can present with areflexia and progressive ascending weakness. A physical examination can be equivocal between the two. In cases where GBS is suspected clinically but initial work-up with cerebral spinal fluid (CSF) studies and magnetic resonance imaging (MRI) of the spine are not diagnostic, nerve conduction study/electromyography (NCS/EMG) should be done to evaluate beriberi neuropathy. Read More

Neurocase 2022 02 20;28(1):123-125. Epub 2022 Feb 20.

Department of Internal Medicine, HCA Houston Healthcare Kingwood, Kingwood, TX, USA.

A 38-year-old male with stage IV gastric adenocarcinoma presented with abdominal pain, nausea, bilious non-bloody vomiting, and lethargy. He was found to have an ileus and was treated appropriately with bowel rest and nasogastric tube decompression. However, the patient was also noted to have confusion and nystagmus. Read More

Rev Neurol (Paris) 2022 Feb 15. Epub 2022 Feb 15.

Division of Neurocritical Care and Hospital Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Electronic address:

Gayet-Wernicke syndrome is an eponym mainly used in France. In this article, we revisit Charles Gayet's (1833-1904) speciality and his patient example that gave rise to the eponym. Charles Gayet attributed the anatomical lesions to inflammation. Read More

Pan Afr Med J 2021 20;40:240. Epub 2021 Dec 20.

Department of Gynecology and Obstetrics, University of Medicine of Sfax, Hedi Chaker Hospital, 3029, Sfax, Tunisia.

Wernicke encephalopathy is a potentially life-threatening neurologic syndrome caused by acute thiamine (vitamin B1) deficiency. It is usually associated with excessive alcohol consumption. Less frequently, this syndrome can be caused by persistent vomiting. Read More

Cureus 2022 Jan 12;14(1):e21180. Epub 2022 Jan 12.

Internal Medicine, University of South Alabama, Mobile, USA.

Micronutrient and vitamin deficiencies in young adults in the United States are relatively rare and often pose a diagnostic challenge. Here, we present the case of a young female who developed acute encephalopathy and muscular weakness two days following an endoscopic procedure performed to investigate the patient's four-month history of intractable nausea, vomiting, dysphagia, and weight loss. She was diagnosed with severe Wernicke encephalopathy due to thiamine deficiency as well as myotonic dystrophy type 1 (DM1). Read More