Wernicke's Encephalopathy & Korsakoff's

Key points

• Wernicke's: thiamine (B1) deficiency — classically confusion, ophthalmoplegia (nystagmus), ataxia (the triad; only minority have all three).
• Korsakoff's: anterograde amnesia with confabulation — often irreversible.
• Treat suspected Wernicke's urgently with parenteral thiamine (Pabrinex).
• Give thiamine BEFORE glucose in at-risk patients (glucose can precipitate Wernicke's).
• Risk groups: alcohol dependence, malnutrition, hyperemesis, malabsorption.

Decision points in this pathway

• Established Korsakoff's?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.