Unusual presentation of Wernicke’s encephalopathy with hypertension

Wernicke’s encephalopathy is an acute neuropsychiatric syndrome caused by thiamine (vitamin B1) deficiency. The classical triad of Wernicke’s encephalopathy is mental confusion, oculomotor dysfunction, and ataxia. It is generally associated with alcoholism and prolonged parenteral nutrition without vitamin supplementation. Wernicke’s encephalopathy must be treated urgently to prevent death and neurological morbidity. In this report, we present an unusual pediatric case of Wernicke’s encephalopathy in which the patient initially presented with hypertension. Intravenous thiamine of 100 mg daily treatment was started, after which she became normotensive. This is the first reported case of Wernicke’s encephalopathy presenting with hypertension and resolved after thiamine treatment.