{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T09:11:24Z","timestamp":1790241084479,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Wernicke's encephalopathy (WE) is an acute neurological disorder that develops due to thiamine (vitamin B1) deficiency. While it is common in chronic alcoholism, WE can also manifest due to other conditions, including extreme fasting. This report presents a unique case of WE occurring after a 40\u2010day water\u2010only fast, emphasizing the importance of recognizing nonalcoholic causes of WE. A 36\u2010year\u2010old male presented with diplopia, gait instability, and confusion following a 40\u2010day water\u2010only fast. Neurological examination revealed bilateral sixth cranial nerve palsy, ataxic gait, and confusion. Magnetic resonance imaging demonstrated bilateral medial thalami and periaqueductal hyperintensities, consistent with WE. He received high\u2010dose intravenous thiamine and electrolyte correction, resulting in substantial improvement. This case underscores the potential occurrence of WE in healthy individuals following extreme fasting. Early identification and treatment with thiamine are essential to prevent irreversible neurological damage. Clinicians should be cautious of WE in at\u2010risk patients without a history of alcohol use.<\/jats:p>","DOI":"10.1002\/ccr3.71049","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T12:07:16Z","timestamp":1761134836000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Wernicke's Encephalopathy Following 40\u2009Days of Water\u2010Only Fasting: A Case Report"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2766-8943","authenticated-orcid":false,"given":"Ruba Adel","family":"Aweer","sequence":"first","affiliation":[{"name":"College of Medicine QU Health, Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor A.","family":"Aweer","sequence":"additional","affiliation":[{"name":"College of Medicine QU Health, Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Tluli","sequence":"additional","affiliation":[{"name":"College of Medicine QU Health, Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8323-1303","authenticated-orcid":false,"given":"Anwar","family":"Joudeh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Al Khor Hospital, Hamad Medical Corporation  Doha Qatar"},{"name":"Internal Medicine, College of Medicine University of Qatar  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468\u20101331.2010.03153.x"},{"key":"e_1_2_12_3_1","volume-title":"StatPearls","author":"Wiley K. 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