- Wernicke's is an underdiagnosed constellation of neuropsychiatric symptoms that include altered mental status, confusion, memory impairment, nystagmus, gaze palsy, and ataxia.
-Symptoms are due to dietary thiamine deficiency that impairs energy utilization in the brain
-Wernicke's is not exclusive to alcoholics. High risk: the elderly, pregnant women, bariatric surgery pts, HIV/AIDs, diabetics, TPN-dependence, and hematologic malignancy
-Treatment: thiamine 200mg IM or IV. ORAL IS NOT EFFECTIVE.
-Treat with parenteral thiamine if a patient is altered, ataxic, has ocular abnormalities, impaired memory, hypotension, or hypothermia.
-We are on the front lines to make this diagnosis. Don't miss it.