If you suspect, then treat! Confirming diagnosis is difficult, treatment is low risk and effective, and morbidity/mortality is high if untreated
Thiamine 500mg IV over 30 min TID x 2 days, then 500mg IV/IM q day for 5 days, then 100mg PO q day until patient no longer at risk
Give magnesium; hypomagnesemic state may be resistant to thiamine administration
Treatment can take days to weeks to work if at all (despite accurate diagnosis)
Give thiamine BEFORE glucose in patients requiring glucose who are at risk for thiamine deficiency; glucose without thiamine can precipitate/worsen WE by driving thiamine intracellularly
Give magnesium; hypomagnesemic state may be resistant to thiamine administration
Treatment can take days to weeks to work if at all (despite accurate diagnosis)
Give thiamine BEFORE glucose in patients requiring glucose who are at risk for thiamine deficiency; glucose without thiamine can precipitate/worsen WE by driving thiamine intracellularly
Wernicke-Korsakoff syndrome
Ethanol toxicity
Sydenham's chorea
Alcohol use disorder
Vaughn Jackson syndrome
Alcohol withdrawal
Wolff–Parkinson–White syndrome
Alcohol withdrawal seizures