{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T03:06:51Z","timestamp":1773198411766,"version":"3.50.1"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Behav. Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Wernicke\u2019s encephalopathy (WE) is an acute neurologic emergency resulting from thiamine deficiency that can cause irreversible injury if treatment is delayed. Although often associated with alcohol use, WE also occurs in the setting of malnutrition, dysphagia, chronic illness, and malignancy. Dysphagia-related WE is rare and typically linked to impaired oral intake. We report a case of a 26-year-old woman with 3\u202fmonths of dysphagia and subsequent poor oral intake who developed WE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>A 26-year-old woman with type 2 diabetes and hypothyroidism presented for confusion, speech incoherence, and gait instability following 3\u202fmonths of dysphagia. She was hemodynamically stable, and her thyroid, autoimmune, toxic, and infectious workups were negative. Although repeated computed tomography was negative, magnetic resonance imaging showed signal changes in the mammillary bodies, posterior midbrain, and medial thalami, indicating Wernicke\u2019s encephalopathy. Her thiamine, folate, and B12 levels were replaced, and her mentation and coordination improved. A swallow study showed no physiologic dysphagia. She was discharged on oral thiamine supplementation and referred to psychiatry for the presumed psychogenic etiology of her dysphagia, given the distressing life events prior to hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>The classic WE triad of confusion, oculomotor abnormalities, and ataxia presents in a minority of patients; hence, atypical presentations may be overlooked. Our patient demonstrated how WE can be induced by nutritional deficiencies secondary to functional or psychogenic dysphagia. Furthermore, this case highlights the importance of prompt clinical intervention via thiamine repletion despite inconclusive initial imaging, as delayed treatment can result in permanent complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnbeh.2026.1780775","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T06:42:00Z","timestamp":1773124920000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Wernicke\u2019s encephalopathy induced by prolonged fasting due to apparent psychogenic dysphagia"],"prefix":"10.3389","volume":"20","author":[{"given":"Logan","family":"Mills","sequence":"first","affiliation":[{"name":"Western Michigan University Homer Stryker MD School of Medicine","place":["Kalamazoo, MI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry","family":"Zou","sequence":"additional","affiliation":[{"name":"Western Michigan University Homer Stryker MD School of Medicine","place":["Kalamazoo, MI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akram","family":"Alnounou","sequence":"additional","affiliation":[{"name":"Western Michigan University Homer Stryker MD School of Medicine","place":["Kalamazoo, MI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morgan","family":"Smeltzer","sequence":"additional","affiliation":[{"name":"Western Michigan University Homer Stryker MD School of Medicine","place":["Kalamazoo, MI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tessa","family":"Kravchenko","sequence":"additional","affiliation":[{"name":"Western Michigan University Homer Stryker MD School of Medicine","place":["Kalamazoo, MI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theotonius","family":"Gomes","sequence":"additional","affiliation":[{"name":"Western Michigan University Homer Stryker MD School of Medicine","place":["Kalamazoo, MI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1515\/jbcpp-2018-0075","article-title":"Review of thiamine deficiency disorders: Wernicke encephalopathy and Korsakoff psychosis","volume":"30","author":"Chandrakumar","year":"2018","journal-title":"J. Basic Clin. Physiol. Pharmacol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"5294","DOI":"10.3390\/nu14245294","article-title":"Wernicke encephalopathy presenting with dysphagia: a case report and systematic literature review","volume":"14","author":"Cornea","year":"2022","journal-title":"Nutrients"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/j.amjoto.2010.01.009","article-title":"Wernicke\u2019s encephalopathy in the course of chemoradiotherapy for head and neck cancer","volume":"32","author":"Fikhman","year":"2011","journal-title":"Am. J. Otolaryngol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1111\/j.1468-1331.2010.03153.x","article-title":"EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy","volume":"17","author":"Galvin","year":"2010","journal-title":"Eur. J. Neurol."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"193","DOI":"10.4103\/sjmms.sjmms_416_22","article-title":"Wernicke encephalopathy: an updated narrative review","volume":"11","author":"Habas","year":"2023","journal-title":"Saudi J Med Med Sci."},{"key":"ref6","first-page":"280","article-title":"Wernicke's encephalopathy, central pontine myelinolysis and supraventricular tachycardia in a case of hyperemesis gravidarum","volume":"34","author":"Huq","year":"2025","journal-title":"Mymensingh Med. J."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1093\/ecam\/nek009","article-title":"A review of the biochemistry, metabolism and clinical benefits of thiamin(e) and its derivatives","volume":"3","author":"Lonsdale","year":"2006","journal-title":"Evid. Based Complement. Alternat. Med."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"503596","DOI":"10.1155\/2014\/503596","article-title":"MR imaging findings in alcoholic and nonalcoholic acute Wernicke\u2019s encephalopathy: a review","volume":"2014","author":"Manzo","year":"2014","journal-title":"Biomed. Res. Int."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.ijscr.2016.01.016","article-title":"Wernicke's encephalopathy after sleeve gastrectomy: literature review","volume":"20","author":"Pardo-Aranda","year":"2016","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1016\/j.soard.2025.03.009","article-title":"ASMBS literature review & clinical guidelines on prevention, diagnosis, and treatment of Wernicke's encephalopathy and Wernicke-Korsakoff syndrome","volume":"21","author":"Patterson","year":"2025","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1177\/23247096231190628","article-title":"Wernicke\u2019s encephalopathy in type 2 achalasia: case report and literature review","volume":"11","author":"Rodriguez","year":"2023","journal-title":"J. Investig. Med. High Impact Case Rep."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1016\/j.mayocp.2019.02.018","article-title":"Wernicke encephalopathy\u2013clinical pearls","volume":"94","author":"Sinha","year":"2019","journal-title":"Mayo Clin. Proc."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1093\/alcalc\/agn103","article-title":"Neuroimaging of the Wernicke-Korsakoff syndrome","volume":"44","author":"Sullivan","year":"2009","journal-title":"Alcohol Alcohol."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1007\/s00455-018-9912-9","article-title":"Medically unexplained oropharyngeal dysphagia at the university hospital ENT outpatient Clinic for Dysphagia: a cross-sectional cohort study","volume":"34","author":"Verdonschot","year":"2019","journal-title":"Dysphagia"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"5810","DOI":"10.12998\/wjcc.v10.i17.5810","article-title":"Non-alcoholic Wernicke encephalopathy in an esophageal cancer patient receiving radiotherapy: a case report","volume":"10","author":"Zhang","year":"2022","journal-title":"World J. Clin. Cases"}],"container-title":["Frontiers in Behavioral Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnbeh.2026.1780775\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T06:42:01Z","timestamp":1773124921000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnbeh.2026.1780775\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,10]]},"references-count":15,"alternative-id":["10.3389\/fnbeh.2026.1780775"],"URL":"https:\/\/doi.org\/10.3389\/fnbeh.2026.1780775","relation":{},"ISSN":["1662-5153"],"issn-type":[{"value":"1662-5153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,10]]},"article-number":"1780775"}}