A-63 Non-Alcoholic Wernicke-Korsakoff Syndrome in a Bariatric Surgery Patient

Objective Wernicke-Korsakoff’s Syndrome (WKS), caused by thiamine deficiency and characterized by altered mental status, amnestic memory loss, confabulation, and lack of awareness, has a global prevalence rate up to 3% and is most commonly observed in alcoholics. Cases of non-alcoholic WKS are exceptionally rare and often go undiagnosed until after the critical treatment period, resulting in permanent brain damage. Despite the paucity of research in this group, there is some evidence that there may be differences in demographic factors, neuroanatomic changes, and cognitive functioning between alcoholic and non-alcoholic WKS patients. Thus, case studies are necessary to understand how non-alcoholic WKS may present and determine whether regular testing in individuals diagnosed with disorders or undergoing medical interventions that can cause thiamine deficiency should be encouraged. Methods Patient is a 65-year-old African American woman with a history of hypothyroidism, obesity, and sleep apnea. She complained of gastrointestinal problems one-month into a pre-bariatric surgery diet. Subsequent medical workups were negative, but she was hospitalized 2–3 months post-symptom onset for thiamine deficiency. Acute neuroimaging was reportedly negative. Results Results from a neuropsychological evaluation indicated temporal disorientation, delusions, and hallucinations. Psychometric testing revealed severe impairments in learning and memory. Some variability was noted in other cognitive domains, but attention, processing speed, executive functioning, language, and visuospatial and motor skills were generally intact. Symptoms of minimal depression and moderate anxiety were endorsed. Conclusion Thiamine deficiency is easily treatable, but different presentations between alcoholic and non-alcoholic cases may complicate diagnosis, delay treatment, and result in WKS. Increased awareness of these differences can inform clinical recommendations.