{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T16:14:35Z","timestamp":1771258475280,"version":"3.50.1"},"reference-count":9,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,2,11]],"date-time":"2016-02-11T00:00:00Z","timestamp":1455148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,2,11]],"date-time":"2016-02-11T00:00:00Z","timestamp":1455148800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:p><jats:italic>Background:<\/jats:italic> Wernicke encephalopathy (WE) is a medical emergency caused by thiamine deficiency, characterized by cerebellar ataxia, ophthalmoplegia, and cognitive disturbances that may progress to Korsakoff amnesia. We describe 2 patients with WE who needed high\u2010dose and long\u2010term treatment with thiamine to obtain neurological improvement and recovery. <jats:italic>Case Description:<\/jats:italic> The first patient was a woman diagnosed with non\u2010Hodgkin lymphoma. After a gastrointestinal infection, she developed depression, memory loss, disorientation, behavioral changes, and ataxic paraplegia. Brain magnetic resonance imaging (MRI) showed bilateral alterations in thalamic, frontal, and periaqueductal regions, suggestive of WE. The second patient was a man who lost 10 kg after surgical gastrectomy; he developed diplopia, ophthalmoplegia, cerebellar ataxia, lower limb paresthesias, and amnesia. A brain MRI demonstrated contrast enhancement of mammillary bodies, compatible with WE. <jats:italic>Outcome:<\/jats:italic> The patients were treated with intramuscular (IM) thiamine (1200 mg\/d for 2 months and 900 mg\/d for a month, respectively) with gradual cognitive and behavioral improvement and brain MRI normalization, while ataxia and oculomotion improved in following months. In both patients, thiamine was gradually reduced to IM 200 mg\/d and continued for a year, without clinical relapses. <jats:italic>Conclusions:<\/jats:italic> There is no consensus about dosage, frequency, route, and duration of thiamine administration in WE treatment. Based on our cases, we recommend treating patients with WE with higher doses of IM thiamine for a longer time than suggested (900\u20131200 mg\/d for 1\u20132 months, in our cases) and to gradually reduce dosage after clinical and radiological improvement, maintaining IM 200 mg\/d dosage for at least 1 year.<\/jats:p>","DOI":"10.1177\/0884533615621753","type":"journal-article","created":{"date-parts":[[2016,2,11]],"date-time":"2016-02-11T23:13:26Z","timestamp":1455232406000},"page":"186-190","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Challenges in Diagnosis and Treatment of Wernicke Encephalopathy"],"prefix":"10.1002","volume":"31","author":[{"given":"Maria Teresa","family":"Infante","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Fancellu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Murialdo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Barletta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucio","family":"Castellan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Serrati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,2,11]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2012.04.008"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70104-7"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuint.2010.11.019"},{"key":"e_1_2_5_5_1","first-page":"CD004033","article-title":"Thiamine for prevention and treatment of Wernicke\u2010Korsakoff syndrome in people who abuse alcohol","volume":"7","author":"Day E","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2010.03153.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/agt034"},{"key":"e_1_2_5_8_1","first-page":"21","article-title":"Wernicke's encephalopathy: role of thiamine","volume":"33","author":"Thomson AD","year":"2009","journal-title":"Pract Gastroenterol"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0884533614561793"},{"key":"e_1_2_5_10_1","first-page":"243","volume-title":"Handbook of Clinical Neurology","author":"Victor M"}],"container-title":["Nutrition in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0884533615621753","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0884533615621753","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0884533615621753","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T08:59:34Z","timestamp":1760950774000},"score":1,"resource":{"primary":{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0884533615621753"}},"subtitle":["Report of 2 Cases"],"short-title":[],"issued":{"date-parts":[[2016,2,11]]},"references-count":9,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,4]]}},"alternative-id":["10.1177\/0884533615621753"],"URL":"https:\/\/doi.org\/10.1177\/0884533615621753","archive":["Portico"],"relation":{},"ISSN":["0884-5336","1941-2452"],"issn-type":[{"value":"0884-5336","type":"print"},{"value":"1941-2452","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,11]]}}}