Treatment of Ethanol Intoxication in Suspected Wernicke Encephalopathy

Ethanol intoxication presenting with features that raise suspicion for Wernicke encephalopathy — a serious condition associated with nutritional deficiency. Prompt recognition is critical when any of the following findings are present alongside intoxication.

Wernicke encephalopathy is a clinical diagnosis. It should be considered in any patient with any combination of suspected nutritional deficiency, altered mental status, oculomotor impairment, and cerebellar dysfunction — including in the context of ethanol intoxication.

Management involves thiamine replacement. The complete protocol specifies the formulation, route, timing, and monitoring parameters that guide safe and timely treatment — these should not be approximated.

Full dosing, sequencing, and clinical guidance are in the complete protocol below.