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The patient was diagnosed with Wernicke encephalopathy and possible peripheral neuropathy secondary to thiamine deficiency. She was started on intravenous thiamine 500\u2009mg three times a day and folate 1\u2009mg one time a day for 3\u2009days and then transitioned to oral thiamine 500\u2009mg along with a multivitamin tablet. Improvement in ophthalmoplegia, weakness, sensation and cognition was noticed after initiating treatment.<\/jats:p>","DOI":"10.1136\/bcr-2024-261292","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T22:30:18Z","timestamp":1724970618000},"page":"e261292","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Atypical presentation of Wernicke encephalopathy due to thiamine deficiency in a patient post sleeve gastrectomy"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1791-7566","authenticated-orcid":false,"given":"Keith","family":"Scharf","sequence":"first","affiliation":[{"name":"Surgery, Loma Linda University School of Medicine, Loma Linda, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2814-1036","authenticated-orcid":false,"given":"Janet","family":"Tang","sequence":"additional","affiliation":[{"name":"School of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6047-9189","authenticated-orcid":false,"given":"Selene","family":"Jamall","sequence":"additional","affiliation":[{"name":"Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8999-7027","authenticated-orcid":false,"given":"Nancy","family":"Baker","sequence":"additional","affiliation":[{"name":"Neurology, Loma Linda University School of Medicine, Loma Linda, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"2025082710160183000_17.8.e261292.1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607114565245"},{"key":"2025082710160183000_17.8.e261292.2","unstructured":"American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) Position Statement . 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