Characterized by the triad of ophthalmoplegia,
gait ataxia, and confusion, this
condition may occur after at least 3 weeks of
persistent vomiting. If patients are treated with
intravenous dextrose without thiamine, metabolism
of the dextrose rapidly consumes the available
B1, triggering acute encephalopathy. In one
case series involving 19 patients in whom this
complication developed, 74% had neurologic abnormalities
on follow-up.9 In some cases, the
diagnosis is made only at autopsy.
Infants of mothers who have lost