A 72-year-old woman is brought to A&E from home with confusion, tremor and ataxia. She drinks a bottle of spirits daily and has eaten very little for ...

Question

A 72-year-old woman is brought to A&E from home with confusion, tremor and ataxia. She drinks a bottle of spirits daily and has eaten very little for several days. Glucose is 3.8 mmol/L. You suspect Wernicke's encephalopathy. What is the most appropriate immediate management?

Accepted Answer

Give intravenous Thiamine before any glucose-containing fluids

Answer

Give intravenous 50% dextrose, then Thiamine

Answer

Give high-dose oral Thiamine only

Answer

Start oral Diazepam and discharge

Answer

Observation only as glucose is normal

uk-plab-1 MCQ (SBA): Wernicke's encephalopathy

A 72-year-old woman is brought to A&E from home with confusion, tremor and ataxia. She drinks a bottle of spirits daily and has eaten very little for several days. Glucose is 3.8 mmol/L. You suspect Wernicke's encephalopathy. What is the most appropriate immediate management?