What should be included in the evaluation of Wernicke-Korsakoff syndrome (WKS)?

Updated: May 16, 2018
  • Author: Glen L Xiong, MD; Chief Editor: David Bienenfeld, MD  more...
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Answer

The primary focus should not necessarily be an accurate diagnosis, but to prevent harm from worsening Wernicke-Korsakoff syndrome in vulnerable patients. If there is clinical uncertainty, patients should be empirically treated while additional evaluations are undertaken.

Initial laboratory studies are directed at the differential diagnostic possibilities that can be identified and corrected rapidly.

Maintain a high level of suspicion for thiamine deficiency to avoid iatrogenic precipitation of Wernicke-Korsakoff syndrome. Heightened awareness should lead to prophylactic supplementation in at-risk patients.

This syndrome is most commonly observed in patients with alcoholism. Consequently, when these patients present to an emergency department, they are routinely administered thiamine prior to glucose infusion.

Several other categories of patients are at increased risk for thiamine deficiency, including inpatients receiving total parental nutrition, which necessitates vigilant monitoring for indicative signs and symptoms to ensure prompt treatment.


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