Abstract
Case of 72 years male with Nonalcoholic Wernickes encephalopathy (NWE) who was initially investigated managed as Stroke, Metabolic encephalopathy or Suspected Meningoencephalitis. Patient managed clinically, until MRI report and with clinical correlation patient was diagnosed with NWE. Thiamine deficiency is associated with chronic alcoholics which was not among the common differentials in this case and its emphasis in ED among the differentials to be ruled out. A male who is Non-alcoholic was brought to ED having Slurred Speech, confusion, weak memory and evaluated, investigated with multiple tests which turned out to be normal Until MRI showed a well defined area of hyper intensity on DWI in peri-ductal region possibility of WE. We recommend using criteria to diagnose and treat NWE as early as possible to avoid misdiagnosis and treatment delays. We should focus on patients with altered mental symptoms even in coma, administering parenteral thiamine.
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