Question

A 48-year-old man with alcohol use disorder presents with confusion, ataxia and nystagmus. You suspect Wernicke encephalopathy. What is the most appropriate immediate treatment?

Accepted Answer

High-dose intravenous thiamine before any glucose

Answer

Large-volume glucose infusion before vitamins

Answer

Oral thiamine only

Answer

No vitamin therapy until MRI confirms diagnosis

Answer

High-dose steroids

Practice question

A 48-year-old man with alcohol use disorder presents with confusion, ataxia and nystagmus. You suspect Wernicke encephalopathy. What is the most appropriate immediate treatment?