Thiamine Deficiency (B1)


  • Vitamin B1 (Thiamine) deficiency

Risk Factors

  • Alcoholic
  • Others w/severe nutritional deficiency


  • Delirium
  • Severe balance problems (ataxia), extremity numbness
  • Occulomotor dysfxn leading to double vision or other occular disturbances
  • Wernickes: most patients wont have all 3 (confusion, ataxia, ophthalmoplegia) symptoms
  • Symptoms resolve w/thiamine, occulmotor most quickly
  • If untreated→ Korsakoff's dementia→ permanent inability to form new memories

Physical Exam Findings

  • Profound confusion
  • Crannial nerve palsey
  • Severe ataxia→ often unable to stand
  • Occulomotor dysfxn including cranial nerve palsey
  • Vertical or horizontal nystagmus