Table 3.

Adequate Treatment of Thiamine Deficiency in Alcohol Users

Problem	Undertreated thiamine deficiency may result in acute irreversible brain damage known as Wernicke-Korsakoff syndrome
Aim	To identify patients at risk of Wernicke-Korsakoff syndrome To treat them adequately
Who is at risk	Chronic alcohol abusers are at risk for thiamine deficiency, especially those who are malnourished
Why	Impact of alcohol on thiamine:
	Poor diet (decreased intake)  Alcohol limits enteric absorption of thiamine  Alcohol increases thiamine demands  Alcohol impairs thiamine liver storage
When to suspect Wernicke-Korsakoff syndrome?	Alcohol misuse plus 1 (or more) of the following:
	Mental status change  Abnormal ocular movements  Ataxia  Unexplained hypotension and hypothermia
Adequate treatment	Only thiamine intravenous for suspected Wernicke-Korsakoff syndrome Oral thiamine is not effective in preventing irreversible brain damage