Links To And Excerpts From The IBCC Chapter, Wernicke’s Encephalopathy

In this post, I link to and excerpt from the Internet Book of Critical Care [TOC] chapter, Wenicke’s Encephalopathy, June 25, 2022 by Dr. Josh Farkas.

All that follows is from the above resource.


  • Failure to consider Wernicke encephalopathy in patients with atypical risk factors (e.g., ICU patients, hyperemesis gravidarum, chronic diuretic use for heart failure).
  • Inadequate dose and duration of thiamine used for patients with Wernicke encephalopathy.  One or two days of IV thiamine isn’t sufficient!
  • Incorrectly excluding the diagnosis of Wernicke encephalopathy because patients lack the classic triad of symptoms (confusion, ataxia, ophthalmoplegia).  In fact, very rarely will patients with Wernicke encephalopathy display all of these components.
  • Inadequate use of thiamine prophylaxis against Wernicke encephalopathy among at-risk critically ill patients.  Oral thiamine is probably adequate for this purpose, making the expense of prophylaxis negligible.


Going further

5-minute summary by Anna Pickens (EM in 5)

This entry was posted in Internet Book Of Critical Care By Dr. Farkas, Internet Book Of Neurocritical Care By Dr. Farkas. Bookmark the permalink.