Abstract
A 36-year-old man was admitted to the emergency ward in a global confusional state. Apart from the patient's name and age no further information on the history was obtainable. Neurological examination revealed intermittent upbeat nystagmus, convergent strabismus, horizontal gaze palsy, and a severe ataxia of stance and gait. Laboratory findings showed an elevation of gamma-glutamyl transpeptidase, serum amylase and serum lipase, and a macrocytic anaemia. Drug and alcohol testing was negative. Based on the classical triad of clinical features—ophthalmoplegia, ataxia, and confusion—Wernicke's encephalopathy was diagnosed and thiamine was administered immediately.
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