Which population is at highest risk for Wernicke encephalopathy due to thiamine deficiency?

Which population is at highest risk for Wernicke encephalopathy due to thiamine deficiency?

• A. Children with dehydration
• B. Chronic alcoholics
• C. Teenagers with viral illness
• D. Elderly with dementia

Answer: (B)

Thiamine deficiency causing Wernicke encephalopathy occurs most commonly in people with chronic alcohol use. Alcohol disrupts thiamine in several ways: it markedly reduces dietary intake, impairs absorption in the gut, damages liver storage and the ability to convert thiamine to its active form, and increases metabolic demands as the body processes alcohol and glucose. Malnutrition and liver disease often accompany heavy drinking, so the brain becomes especially vulnerable to thiamine shortage. Among the groups listed, someone with chronic alcoholism carries both the highest likelihood of insufficient thiamine and the greatest risk of developing the encephalopathy, even before other factors come into play. The other scenarios can involve malnutrition or illness, but they do not carry the same consistently high risk as prolonged alcohol abuse. In practice, if thiamine deficiency is suspected, treat promptly with thiamine before giving glucose to prevent precipitating or worsening encephalopathy.

Thiamine deficiency causing Wernicke encephalopathy occurs most commonly in people with chronic alcohol use. Alcohol disrupts thiamine in several ways: it markedly reduces dietary intake, impairs absorption in the gut, damages liver storage and the ability to convert thiamine to its active form, and increases metabolic demands as the body processes alcohol and glucose. Malnutrition and liver disease often accompany heavy drinking, so the brain becomes especially vulnerable to thiamine shortage.

Among the groups listed, someone with chronic alcoholism carries both the highest likelihood of insufficient thiamine and the greatest risk of developing the encephalopathy, even before other factors come into play. The other scenarios can involve malnutrition or illness, but they do not carry the same consistently high risk as prolonged alcohol abuse.

In practice, if thiamine deficiency is suspected, treat promptly with thiamine before giving glucose to prevent precipitating or worsening encephalopathy.