TITLE:
Can Wernicke’s Encephalopathy Be Precipitated by Administering Glucose before Thiamine in Severely Malnourished or Alcoholic Patients?
AUTHORS:
Joshua Altman, Matthew F. Ryan
KEYWORDS:
Wernicke’s Encephalopathy, Thiamine, Glucose
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.8 No.9,
September
18,
2019
ABSTRACT: We discuss the safety and controversy regarding the administration of glucose before thiamine with regards to precipitation of Wernicke’s Encephalopathy in the severely malnourished and alcoholic patient population. Herein we review clinical features, pathophysiology and the relevant literature to provide an evidenced-based recommendation that thiamine replacement should not delay glucose administration acutely in the malnourished patient population.