Abstract

Wernicke’s encephalopathy is heterogeneously defined, treatable, and reported in a number of disorders that cause thiamine deficiency. Despite well-documented approaches to diagnosis and treatment of this neurological condition, thiamine dosing guidelines remain inconsistent and understudied. Furthermore, identification of symptoms is often delayed or missed entirely. This review explores the historical evolution of Wernicke’s encephalopathy, its pathophysiology, clinical presentation in hospitalized patients, and treatment considerations. We discuss a structured paradigm for inpatient evaluation and special considerations for high-risk populations, including pregnant patients, older adults and individuals with co-occurring substance use beyond alcohol consumption. Wernicke’s encephalopathy remains a clinical diagnosis, though evolving understanding of its etiology, presentation, and epidemiology presents opportunity for earlier detection and treatment. 

Keywords

Wernicke’s encephalopathy, alcohol use disorder, thiamine deficiency