{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:16:59Z","timestamp":1782602219192,"version":"3.54.5"},"reference-count":12,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2018,12,12]]},"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:p>Thiamine is an important coenzyme, which is essential for metabolism and maintaining cellular osmotic gradient. Thiamine deficiency can cause focal lactic acidosis, alteration of the blood\u2013brain barrier and the production of free radicals through cell death by necrosis and apoptosis. Wernicke encephalopathy (WE) is a clinical diagnosis. Cytotoxic and vasogenic oedema are the most typical neuroimaging findings of WE, presenting as bilateral symmetrical hyperintense signals on T2-weighted MR images. MRI is not necessary for the diagnosis of WE, but it can be helpful in ruling out alternative diagnosis. We present the case of an 61-year-old man with the history of class II obesity presenting with diplopia, dysarthria and vertigo, confirmed to be non-alcoholic WE. We aim to highlight the occurrence of WE in patients with large bowel resection though. Delay in diagnosis, particularly in obese individuals due to lack of suspicion, can lead to grim prognosis.<\/jats:p>","DOI":"10.1136\/bcr-2018-227731","type":"journal-article","created":{"date-parts":[[2018,12,28]],"date-time":"2018-12-28T04:55:13Z","timestamp":1545972913000},"page":"e227731","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Non-alcoholic Wernicke encephalopathy: great masquerader"],"prefix":"10.1136","volume":"11","author":[{"given":"Chukwudumebi","family":"Okafor","sequence":"first","affiliation":[{"name":"Internal Medicine, Presence Saint Joseph Hospital Chicago, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manojna","family":"Nimmagadda","sequence":"additional","affiliation":[{"name":"Internal Medicine, Presence Saint Joseph Hospital Chicago, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2714-5923","authenticated-orcid":false,"given":"Sarthak","family":"Soin","sequence":"additional","affiliation":[{"name":"Internal Medicine, Presence Saint Joseph Hospital Chicago, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lavanya","family":"Lanka","sequence":"additional","affiliation":[{"name":"Internal Medicine, John H Stroger Hospital of Cook County, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,12,27]]},"reference":[{"key":"2025082800140816000_11.1.e227731.1","unstructured":"Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline. 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Wernicke\u2019s encephalopathy: increasing clinician awareness of this serious, enigmatic, yet treatable disease. 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