WE occurs with chronic alcoholism and thiamine deficiency. If untreated, WE patients can develop KS, a severe neurological disorder characterized by anterograde amnesia (Harper 2006; Zahr et al. 2011). Malnutrition, vomiting, and diarrhea are common in chronic alcoholism and can contribute to thiamine deficiency (Fields et al. 1994; Gloria et al. 1997; Morgan 1982; Ross et al. 2012). Further, the gastrointestinal tract’s ability to absorb necessary quantities of thiamine is diminished in alcoholics (Hoyumpa 1980; Thomson 2000), and the liver, which houses a large part of the body’s supplies of thiamine, may not be able to store thiamine in the same capacity if it is in a diseased state (Butterworth 2009; Levy et al. 2002). Classical clinical signs of WE included visual, gait, and mental disturbances (Victor et al. 1971), but more recent assessments describe mild, moderate, and severe signs and symptoms including anorexia, loss of memory, and emotional changes (Thomson et al. 2008). An MRI image of acute WE (see figure 2) has symmetrical bright spots, or hyperintensities, clearly visible on T2-weighted images, and those created by fluid attenuation
