Abstract
Wernicke´s encephalopathy is not diagnosed in the considerable part of patients. The risk of Wernicke´s encephalopathy must be considered not only in patients with alcohol abuse, but in patients with chronic vomiting, nutritional deficit, after abdominal surgery, with increased energy demand (pregnancy, thyrotoxicosis), or in oncology too.
The diagnosis is based on patient’s history and clinical picture. The delirium, oculomotor disturbances and lower limb ataxia with unsteadiness of gait belong among classical symptoms of the disease.
The clinical picture is often incompletely expressed. Magnetic resonance imaging is helpful for diagnosis only in one half of the patients.
Serum thiamin level or erythrocyte transketolase activity assessments do not belong to routine laboratory tests. Wernicke´s encephalopathy as a complication of home parenteral nutrition and in a patient after a bariatric surgery is described in the form of case reports by authors.
It is important not to forget thiamine deficiency prevention in risk patients on the one hand. Adherence of patients to the recommended vitamin substitution must be improved by repeated educations and motivation on the other hand.