Acute Wernickes Encephalopathy precipitated by glucose loading

Four cases of acute Wernickes Encephalopathy in non-alcoholic, malnourished patients are described. In each case the administration of a glucose load precipitated a neurological crisis which was rapidly reversed by the administration of intravenous Thiamine. It is suggested that prophylactic Thiamine treatment therapy should be considered in the management of all malnourished patients.