Malnutrition: An Underdiagnosed Cause of Wernicke's Syndrome

Abstract

Wernicke syndrome is an underdiagnosed condition, and many cases are not identified in life. The main cause is alcohol abuse, however there are others less evident as malnutrition or bariatric surgery. Generally, this disease
presents with neurological symptoms such as: confusion,
ophthalmoplegia and ataxia. The diagnosis is primarily clinical and often confirmed days later. Magnetic resonance imaging findings are not pathognomonic but can corroborate the diagnosis. Early thiamine treatment is necessary to avoid permanent neurological deficits or even death. We present a case of thiamine deficiency due to malnutrition in an obese patient recently submitted to bariatric surgery. The authors’ purpose is to alert to the importance of maintaining a high level of suspicion for thiamine deficiency, even in patients without history of alcohol abuse for successful outcome.