<unk> ’s Encephalopathy: acute neurologic symptoms caused by thiamine deficiency<unk> ’s Psychosis: chronic neurologic symptoms caused by thiamine deficiency<unk>  <unk> : presence of<unk> 's Encephalopathy +<unk> 's Psychosis simultaneously
Only 20% identified before death, failure of diagnosis leads to 20% mortality and 75% permanent damage
Thiamine plays critical role in:
Energy production pathways (Kreb's cycle, pentose phosphate pathway, alpha-ketoglutarate dehydrogenase, pyruvate dehydrogenase)
Deficiency leads to lactic acidosis, altered brain metabolism
Lipid metabolism (including myelin sheath formation)
Alterations in myelination leads to peripheral neuropathy
Brain lesions/atrophy usually occur in: mamillary bodies (nearly all cases), thalamus, periaqueductal gray matter, 3rd/4th ventricle, cerebellum, frontal lobe
Energy production pathways (Kreb's cycle, pentose phosphate pathway, alpha-ketoglutarate dehydrogenase, pyruvate dehydrogenase)
Deficiency leads to lactic acidosis, altered brain metabolism
Lipid metabolism (including myelin sheath formation)
Alterations in myelination leads to peripheral neuropathy
Deficiency leads to lactic acidosis, altered brain metabolism
Alterations in myelination leads to peripheral neuropathy
Thiamine (vitamin B1) deficiency caused by
Insufficient intake (e.g. chronic alcoholism, starvation/anorexia, severe vomiting/diarrhea, unbalanced TPN)
Malabsorption (post-gastrectomy, IBD, pancreatitis)
Increased metabolic requirements (malignancy, thyrotoxicosis)
Thiamine losses (hemodialysis)
Miscellaneous: AIDS, liver disease
Insufficient intake (e.g. chronic alcoholism, starvation/anorexia, severe vomiting/diarrhea, unbalanced TPN)
Malabsorption (post-gastrectomy, IBD, pancreatitis)
Increased metabolic requirements (malignancy, thyrotoxicosis)
Thiamine losses (hemodialysis)
Miscellaneous: AIDS, liver disease<unk> 
Beriberi
Wernicke-Korsakoff syndrome
Ethanol toxicity
Sydenham's chorea
Alcohol use disorder
Vaughn Jackson syndrome
Alcohol withdrawal
Wolff–Parkinson–White syndrome
Alcohol withdrawal seizures