Table 7

 Management of Wernicke-Korsakoff syndrome

Detection: Consider in all cases of alcohol withdrawal, alcohol misuse and dependence, head injury, and acute confusional states. The classical triad of symptoms is not required for diagnosis
Assess nutritional status: Patients should be asked about their diet, recent vomiting/diarrhoea, and weight loss
Treatment of Wernicke-Korsakoff syndrome: British National Formulary recommends 2–3 pairs of high potency intravenous Pabrinex injections every 8 hours. This should be reassessed after 3 days, by when a noticeable improvement should have occurred and treatment should continue as long as clinical improvement continues.7
Patients at risk of Wernicke-Korsakoff syndrome: One pair of ampoules is recommended for 3–5 days in alcohol misusers at risk of Wernicke-Korsakoff syndrome—that is, those with a history of malnutrition, weight loss, diarrhoea, vomiting or physical illness.7,8
Optimal aftercare: Appropriate and supportive placement; maintenance of abstinence