Prognosis
Prognosis is dependent on the presentation of the vitamin B1 deficiency and how quickly treatment is instituted. Exact figures regarding recovery and complications are difficult as this is a frequently under-diagnosed condition.
Wernicke's encephalopathy
Untreated, 20% of patients will die. Of the survivors, estimates of progression to Korsakoff psychosis (a condition characterised by retrograde and anterograde amnesia causing the inability to memorise new information) and confabulation (inventing events in order to compensate for lack of memory), but with general preservation of other intellectual functions, range between 50% to 85%.[54] Of those who develop Korsakoff's psychosis, 25% will require long-term institutional care.[55]
While ataxia and eye movements improve with thiamine replacement, there is little evidence on the effects on memory and the prevention of Korsakoff's psychosis.[54][56]
Wet beriberi
Untreated, wet beriberi, and particularly Shoshin beriberi, can result in death. Treatment with parenteral thiamine should result in significant improvement in the first 24 hours of therapy.
Dry beriberi
With thiamine replacement, resolution of symptoms can take weeks to months. In some cases, symptoms may never fully resolve, particularly if there is a coexisting additional cause of neuropathy such as alcohol abuse or diabetes.
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