Non-Alcoholic Wernicke Encephalopathy: A Literature Review

Non-Alcoholic Wernicke Encephalopathy (NAWE) is a severe neurological disorder caused by thiamine (vitamin B1) deficiency due to non-alcoholic ethology such as malnourishment, gastrointestinal disorders, hyperemesis gravidarum, and chronic conditions. Even though Wernicke Encephalopathy (WE) is traditionally associated with chronic alcoholism, the incidence of NAWE is increasing but underdiagnosed due to its nonspecific presentations as compared to other neurological disorders. It is also prone to delayed diagnosis and induces irreversible damage. Although the classical triad of confusion, ataxia, and ophthalmoplegia is common, symptoms are often incomplete in patients who do not have alcoholism, and it may be difficult to diagnose. MRI is beneficial in detecting typical brain lesions. Thiamine deficiency also occurs more commonly in patients undergoing dialysis, bariatric surgery, and psychiatric illnesses, especially schizophrenia, where neglect of self-care and restriction of diet augment the risk. Studies show that giving thiamine intravenously early can greatly reduce the risk of serious problems, but delays may lead to Wernicke-Korsakoff syndrome. Promptness and awareness are of utmost significance in optimizing patient prognosis. This review will elaborate on the analysis of etiologies, clinical presentation, risk factors, and treatment modalities of NAWE to create an overall scenario of this syndrome and optimize the result of early diagnosis and treatment.