E51.2

Clinical Causes: Chronic alcohol consumption leading to poor nutrition and impaired absorption of thiamine Malnutrition or starvation Malabsorption syndromes such as Crohn's disease or celiac disease Prolonged vomiting or gastrointestinal issues Certain medical conditions requiring long-term intravenous feeding without adequate vitamin supplementation Patients undergoing bariatric surgery

Key Symptoms: Confusion or disorientation Loss of muscle coordination (ataxia), especially affecting gait Ophthalmoplegia, including abnormal eye movements and nystagmus Difficulty speaking or swallowing Memory problems or amnesia Approach to coma in severe cases Other neurological deficits such as double vision or drooping eyelids

Diagnosis Path: Diagnosis primarily relies on clinical evaluation, considering the patient's history and presenting symptoms. Medical professionals may perform neurological examinations and utilize neuroimaging techniques like MRI to identify characteristic brain changes. Blood tests can assess thiamine levels, though clinical suspicion often guides treatment initiation even before laboratory results are available.

Treatment Protocols: Immediate treatment involves high-dose thiamine supplementation, typically administered intravenously or intramuscularly. Addressing underlying causes such as malnutrition or alcohol dependence is crucial. Early intervention can reverse symptoms and prevent progression to more severe conditions like Korsakoff syndrome, which involves permanent memory impairment. Additional supportive measures include correcting electrolyte imbalances, maintaining hydration, and providing nutritional support to promote recovery.