Reversible coma in Wernicke's encephalopathy

Area of Science:

• Neurology
• Critical Care Medicine

Background:

• Wernicke's encephalopathy is a neurological emergency.
• It is often associated with thiamine deficiency.
• Coma and respiratory failure are severe complications.

Observation:

• A case of coma due to Wernicke's encephalopathy with respiratory failure is presented.
• Diagnostic features can be subtle, but pupillary and ocular signs are suggestive.
• Structural brain disease must be excluded for accurate diagnosis.

Findings:

• Ventilation and thiamine administration resulted in patient recovery.
• Korsakoff's psychosis and ataxia persisted despite treatment.
• Thiamine response can be diagnostic, observed in 8 reviewed patients.
• Long-term morbidity remains significant even with treatment.

Implications:

• Early diagnosis and treatment of Wernicke's encephalopathy are crucial.
• Prompt thiamine administration can reverse coma and respiratory failure.
• Neurological deficits may persist, highlighting the importance of prevention.