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.
- Rapid Reference
- Signs & Symptoms
- Risk factors
- Laboratory studies
- Differential diagnosis & securing the diagnosis
- Questions & discussion
- Don’t Wernicke’s, B(1) Happy (Tox & Hound, by Meghan Spyres)
- Wernicke Encephalopathy (RebelEM, by Anand Swaminathan) and also a podcast.
- Wernicke encephalopathy (Radiopaedia, by Craig Hacking and Frank Gaillard)
5-minute summary by Anna Pickens (EM in 5)