with this disorder presented with the full triad of clinical features and ≈30% of such indivi duals exhibited only cognitive impairment.21 Thus, through the requirement of the full triad for a positive diagnosis, WE is missed by routine clinical examination in 75–80% of cases, even in teaching hospitals. By contrast, the presence of just two of four signs (dietary deficiency, ocular motor abnormality, cerebellar dysfunction, and either altered mental state or mild memory impairment), which was first suggested by Caine and colleagues22 and is now recommended by the EFNS,16 can significantly improve the diagnostic accuracy for WE.
