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However, in current times, Wernicke\u2019s encephalopathy is also well recognized in many other patient groups, including patients following bariatric surgery, gastrointestinal surgery, cancer and pancreatitis. Early recognition of Wernicke\u2019s encephalopathy is vital, as prompt treatment can restore cognitive or ocular function and can prevent permanent disability. Unfortunately, Wernicke\u2019s encephalopathy is often undiagnosed \u2013 presumably because it is relatively uncommon and has a variable clinical presentation. Clinical biochemists have a unique role in advising clinicians about potential nutritional or metabolic causes of unexplained neurological symptoms and to prompt consideration of thiamine deficiency as a potential cause in high-risk patient groups. The aim of this review is to summarize the clinical features, diagnosis and treatment of Wernicke\u2019s encephalopathy and to highlight some non-traditional causes, such as after bariatric surgery.<\/jats:p>","DOI":"10.1177\/0004563220939604","type":"journal-article","created":{"date-parts":[[2020,6,19]],"date-time":"2020-06-19T07:46:50Z","timestamp":1592552810000},"page":"38-46","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":81,"title":["Don\u2019t seek, don\u2019t find: The diagnostic challenge of Wernicke\u2019s encephalopathy"],"prefix":"10.1177","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0063-9037","authenticated-orcid":false,"given":"Sara","family":"Kohnke","sequence":"first","affiliation":[{"name":"Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Addenbrooke\u2019s Hospital, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire L","family":"Meek","sequence":"additional","affiliation":[{"name":"Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Addenbrooke\u2019s Hospital, Cambridge, UK"},{"name":"Department of Clinical Biochemistry, North West Anglia NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK"},{"name":"Wolfson Diabetes and Endocrinology Clinic, Cambridge University Hospitals, Addenbrooke\u2019s Hospital, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,7,13]]},"reference":[{"key":"bibr1-0004563220939604","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.49.4.341"},{"key":"bibr2-0004563220939604","first-page":"1362","volume":"86","author":"Scalzo SJ","year":"2015","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"bibr3-0004563220939604","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S130078"},{"key":"bibr4-0004563220939604","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2018.01.009"},{"key":"bibr5-0004563220939604","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70104-7"},{"key":"bibr6-0004563220939604","doi-asserted-by":"publisher","DOI":"10.4103\/0972-2327.120467"},{"key":"bibr7-0004563220939604","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(89)90095-6"},{"key":"bibr8-0004563220939604","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(82)90145-9"},{"key":"bibr9-0004563220939604","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.alcalc.a008400"},{"key":"bibr10-0004563220939604","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2010.03153.x"},{"key":"bibr11-0004563220939604","doi-asserted-by":"publisher","DOI":"10.1007\/BF01991779"},{"key":"bibr12-0004563220939604","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.52.10.1217-a"},{"key":"bibr13-0004563220939604","first-page":"21","volume":"33","author":"Thomson AD","year":"2009","journal-title":"Pract Gastroenterol"},{"key":"bibr14-0004563220939604","volume-title":"Modern nutrition in health and disease","author":"Tanphaichitr V.","year":"1999"},{"key":"bibr15-0004563220939604","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-4159.1989.tb07297.x"},{"key":"bibr16-0004563220939604","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0013616"},{"key":"bibr17-0004563220939604","doi-asserted-by":"publisher","DOI":"10.1079\/PHN19980018"},{"key":"bibr18-0004563220939604","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-3010.2004.00442.x"},{"key":"bibr19-0004563220939604","unstructured":"Clark DD, Sokoloff L. 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