Non Alcoholic Wernicke’s Encephalopathy with Cortical Involvement in a Patient of Active Peptic Ulcer Disease

Wernicke’s encephalopathy is an acute neurological syndrome due to thiamine deficiency. Though classically described in relation to chronic malnutrition associated with alcoholism, it can also be precipitated in nonalcoholics due to various causes like gastrointestinal surgeries, recurrent vomiting, peptic ulcer disease, cancer chemotherapy and peritoneal or hemodialysis [1]. As the classical triad of confusion, ophthalmoplegia and ataxia is rarely present; a high index of clinical suspicion has to be maintained in non-alcoholics for the early diagnosis of Wernicke’s encephalopathy. An early diagnosis and prompt institution of thiamine replacement leads to improvement in symptoms and prevents long term sequelae. We present this case to highlight peptic ulcer disease as a cause precipitating Wernicke’s encephalopathy.