Table 4.

Initial diagnosis incorrect‐ consider “MIND” disorders: N = nutritional.

Condition	Clinical Clues	Additional Investigations
Nutritional
Thiamine (Vitamin B1)	−Wernicke's Encephalopathy: Confusion, Ataxia, Ophthalmoplegia −Korsakoff Syndrome: Amnesia, confabulation +/‐Thiamine Neuropathy +/‐Cardiac involvement	Serum thiamine levels (rarely useful‐long turnaround time) −Treat upon suspicion
Vitamin B121	−Subacute combined degeneration of the spinal cord +/‐ neuropathy, cognitive changes(rare)	Low serum vitamin B12 Elevated homocysteine and methylmalonic acid Macrocytic anemia with Hypersegmented neutrophils
Copper 1	−Similar syndrome to Vitamin B12 deficiency. −At risk: bariatric surgery, excess zinc supplementation	Low serum copper Low serum ceruloplasmin

¹Presentation usually largely dominated by peripheral nervous system involvement. CNS signs rare, but occasionally reported