Non-alcoholic Wernicke–Korsakoff Syndrome: A Narrative Review

Non-alcoholic Wernicke–Korsakoff Syndrome (NA-WKS) is an under-recognised, thiamine-deficiency-mediated neurological disorder. While classically linked to chronic alcoholism, NA-WKS occurs in non-alcoholic patients. NA-WKS usually presents with episodes of anterograde amnesia accompanied by oculomotor signs, which occur more frequently than in alcoholic WKS. NA-WKS typically follows bariatric surgery, hyperemesis gravidarum, cancer cachexia, eating disorders, chronic kidney disease, or the use of certain oncologic or antidiabetic agents and chronic infectious diseases (e.g., immunodeficiency syndrome, tuberculosis, severe infections). Late diagnosis remains one of the leading factors for irreversible cognitive impairment. High-dose intravenous thiamine can reverse acute Wernicke encephalopathy when given early and prevent long-term damage. This review aims to provide clinicians with evidence based guidance regarding NA WKS to facilitate early recognition, timely treatment, and improved patient outcomes.