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Caused by thiamine deficiency
In United States, occurs most commonly in patients with alcohol use disorder
It may also occur in patients with AIDS, in patients with hyperemesis gravidarum, or after bariatric surgery
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Wernicke syndrome
Triad of confusion, ataxia, and nystagmus leading to ophthalmoplegia (lateral rectus muscle weakness, conjugate gaze palsies)
Peripheral neuropathy may be present
Korsakoff syndrome
Occurs in more severe cases of thiamine deficiency
Includes anterograde and retrograde amnesia and sometimes confabulation
May not be recognized until after an initial delirium has lifted
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In suspected cases, thiamine 100 mg, is given intravenously immediately and then intramuscularly on a daily basis until a satisfactory diet can be ensured after which the same dose is given orally
Initial doses of 200–500 mg intravenously three times daily for the first 5–7 days of treatment has been recommended
Intravenous glucose given before thiamine may precipitate the syndrome or worsen the symptoms