Classic Presentation and Signs

Show Notes

Take Home Points

1. Consider the diagnosis in all patients with nutritional deficiencies, not just alcoholics.
2. Look for ophthalmoplegia, ataxia and confusion in patients that have risk factors for thiamine deficiency.
3. Don’t think that it can’t be Wernicke’s because the triad isn’t complete; any two of the components (dietary deficiency, oculomotor abnormalities, cerebellar dysfunction or altered mental status) makes the diagnosis.
4. Treat Wernicke’s with an initial dose of 500 mg of thiamine IV and admit for continued parenteral therapy.

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