From psychosis to Wernicke encephalopathy: a case of hunger strike in prison

Wernicke encephalopathy (WE) is a neuropsychiatric condition associated with  thiamine deficiency that includes a triad of mental status changes, ophthalmoplegia, and ataxia. Worsening WE may lead to Korsakoff syndrome(KS), in which cognitive impairments such as confabulation and memory deficits and also psychiatric symptoms may occur. Diagnosis of Wernicke-Korsakoff syndrome can be complicated in many cases. We present the case of a prisoner who commenced a hunger strike and developed WE. The preceding factors were associated with his oral intake refusal, which originated from his mental disorder with psychotic content. We discuss the clinical and treatment concerns for this complicated condition.