Wernicke Encephalopathy in a Patient With Bipolar Disorder: A Case Report

Wernicke encephalopathy (WE) is a combination of neurological findings including confusion, ataxia, and ophthalmoplegia. It most commonly associated with patients who have history alcohol abuse. This aspect leads to the majority cases going undiagnosed in non-alcoholic other potential thiamine deficiency-causing conditions such as malignancy, chronic kidney disease (CKD) on hemodialysis, hyperemesis gravidarum, psychiatric disorders leading starvation malnourishment. Here we present case 59-year-old female patient decompensated bipolar disorder came altered mental status multiple syncopal episodes. On examination, she was completely confused had fixed gaze. She worked up for broad differential diagnoses stroke, arrhythmias, seizures, drug intoxication, infections. But due her severely malnourished appearance, Wernicke’s suspected early on, started therapy, which responded well. also confirmed by an MRI brain showing flair bilateral medial thalamic region. Therefore, suspect presence WE differentiate behavioral symptoms from delirium difficult requires high degree clinical suspicion.