- May occur after as little as 2 weeks of persistent vomiting or as a result of bypass of the jejunum
- T ½ 9-18 days
- Causes:
- Peripheral neuropathy, fatigue, irritability,
- Wernicke Encephalopathy
- Ophthalmoplegia
- Nystagmus
- Ataxia
- Apathy
- Coma
- Korsakoff psychosis
- Confusion
- Dysphonia
- Confabulation
- Dry Beriberi (Peripheral nervous system)
- Bilateral symmetric, stocking-glove distribution paraesthesias/dysesthesias
- Muscular cramps and muscular wasting
- Wet Beriberi (Cardiovascular)
- Vasodilation, tachycardia, wide pulse, warm skin, lactic acidosis, CHF and shock
- Anaemia
- Give IV multi-vits, if in doubt give thiamine 100mg IV
- NB: Test takes 1 week so treat empirically