Wernicke encephalopathy (WE) is the main neurologic complication of thiamine deficiency. Thiamine is a cofactor for several key enzymes important in energy metabolism. WE is a little-recognised and underdiagnosed condition, and the prevalence in the elderly is unknown. The classic triad of WE includes encephalopathy, oculomotor dysfunction, and gait ataxia. Diagnosis is clinical, and early treatment with thiamine is fundamental in preventing coma and death. In the cases reported in the literature, the cause of WE was fasting or malnutrition in 10.2% of cases. WE may in some cases constitute a public health problem. Being the prevalence unknown, we alert clinicians to keep severe malnutrition in elderly as a form of precipitation of WE. We review the cases published in the literature.
Part of the book: Malnutrition