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Wernicke encephalopathy — UKMLA MCQ

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EasyNeurologyWernicke encephalopathyUKMLA

A 59-year-old man with chronic alcohol use presents with confusion, ataxia, and nystagmus. What is the immediate treatment?

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Correct answer: BIV thiamine before glucose

Wernicke encephalopathy requires immediate IV thiamine before any glucose to prevent worsening neurologic injury; giving dextrose first may precipitate deterioration. Haloperidol/steroids/folate do not treat the thiamine deficiency.

Reference: Secondary Source: AAN Practice Guideline (2010, most recent) Wernicke Encephalopathy management