A Case of Prolonged Wernicke's Encephalopathy Successfully Treated With Long-Term High-Dose Thiamine.

Wernicke's encephalopathy (WE) is a neurological disorder caused by thiamine deficiency. This condition is characterized by impaired consciousness, eye movement disorders, and gait ataxia. Early diagnosis and thiamine treatment are critical owing to the condition's high mortality rate and risk of progression to Korsakoff syndrome. However, WE is often underdiagnosed, and treatment guidelines remain limited. In this case study, we report the case of a patient diagnosed with WE shortly after improvement from alcohol withdrawal delirium. High-dose thiamine administration for approximately nine weeks resulted in a marked improvement in consciousness. This case underscores the importance of considering WE in patients with alcohol use disorder who exhibit episodes of impaired consciousness and poor food intake, specifically when guided by Caine's criteria. It also highlights the potential benefit of high-dose intravenous thiamine administration, particularly in the early stages of treatment, and suggests that prolonged treatment may still yield improvements, even in cases with delayed recovery.