title: High-dose Parenteral Thiamine in Treatment of Wernicke's Encephalopathy: Case Series and Review of the Literature.
abstract: Thiamine deficiency can lead to Wernicke's encephalopathy (WE), an acute and potentially life-threatening neurological disorder. Even though the main treatment modality for WE consists of thiamine replacement, evidence supporting an optimal dosing strategy and duration is unclear.
  
  
  
  We present a single-center case series of eleven patients that were admitted with possible WE and treated with high-dose parenteral thiamine.
  
  
  
  Patients with suspected WE were treated with ≥500 mg intravenous thiamine for a median of 3 days with 73% of patients (eight out of eleven) displaying symptom resolution or improvement after treatment. No significant correlation between symptom resolution and timing of high-dose thiamine initiation (median=92 h) was identified. In patients whose symptoms resolved compared to those whose symptoms did not, there were no differences in patient variables nor adverse effects related to thiamine treatment.
  
  
  
  High-dose thiamine (≥500 mg) appears safe and efficacious for use in patients with suspected WE.
authors.affiliation: Department of Pharmacy, Methodist University Hospital, Memphis, TN, U.S.A.|Department of Clinical Pharmacy, University of Tennessee, Memphis, TN, U.S.A.
authors.forename: Andrew
authors.initials: A
authors.lastname: Nishimoto
authors.affiliation: Department of Pharmacy, Methodist University Hospital, Memphis, TN, U.S.A.|Department of Clinical Pharmacy, University of Tennessee, Memphis, TN, U.S.A.
authors.forename: Justin
authors.initials: J
authors.lastname: Usery
authors.affiliation: Inpatient Physicians, Methodist Germantown Hospital, Memphis, TN, U.S.A.
authors.forename: John C
authors.initials: JC
authors.lastname: Winton
authors.affiliation: Department of Pharmacy, Methodist University Hospital, Memphis, TN, U.S.A. Jennifer.Twilla@mlh.org.|Department of Clinical Pharmacy, University of Tennessee, Memphis, TN, U.S.A.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Twilla
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D013831:Thiamine / Q000627:therapeutic use*; D013832:Thiamine Deficiency / Q000150:complications*; D014803:Vitamin B Complex / Q000627:therapeutic use*; D014899:Wernicke Encephalopathy / Q000188:drug therapy* / Q000209:etiology
chemical_list: D014803:Vitamin B Complex; D013831:Thiamine
keywords: Thiamine; Wernicke's encephalopathy; alcohol; vitamin B1