Case challenge · Neurology / Emergency / Nutrition · teaching
Wernicke Encephalopathy — Management Pathway · case challenge
Given a case, work through the care pathway step by step; the tool checks each choice and scores you. Decisions and basis are taken from this site's reviewed care pathways.
← View the full flowchartBased on Caine criteria
Case #1Neurology / Emergency / Nutrition
📋 Case data
- Suspected Wernicke?Does not fit
Data is taken from this pathway's reviewed node text. Work through the pathway step by step.
Step 1 / 1 · Suspected Wernicke?
High-risk + neurological signs — suspected Wernicke (Caine criteria)?
💡 Thiamine (B1) deficiency causing an acute neurological emergency. The triad (altered consciousness + ophthalmoplegia/nystagmus + ataxia) is complete in only ~16% (do not wait), altered consciousness is most common; untreated → Korsakoff (permanent memory impairment). High-risk: alcohol use + malnutrition, post-bariatric surgery, hyperemesis gravidarum, dialysis, malignancy, prolonged vomiting. Caine criteria (≥2/4, 85% sensitive): dietary deficiency, oculomotor abnormality, cerebellar dysfunction, altered consciousness/memory.
For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.