Thiamine refractory Wernickes encephalopathy reversed with magnesium therapy

Hypomagnesaemia may result in thiamine refractoriness in patients with Wernickes encephalopathy. 2 Some studies have suggested that thiamine deficiency leads to Wernicke-Korsakoff syndrome only in patients whose transketolase has a reduced affinity for thiamine. 3 Learning points Patients with a history of excess alcohol often present with electrolyte abnormalities including hypomagnesaemia.