The Royal College of Physicians report on alcohol: guidelines for managing Wernicke's encephalopathy in the accident and Emergency Department

Alcohol Alcohol. 2002 Nov-Dec;37(6):513-21. doi: 10.1093/alcalc/37.6.513.


The Royal College of Physicians (London) recently published its latest report on alcohol misuse entitled 'Alcohol - Can the NHS Afford It?'. Part of this document, encompassing our views, has made specific recommendations for the management of patients in the Accident and Emergency (A&E) Department who may possibly have, or are at risk of developing, Wernicke's encephalopathy. Patients showing evidence of chronic alcohol misuse and suspected of having a poor diet should be treated at the outset with B vitamins intravenously or intramuscularly, especially when the clinical signs are initially masked by drunkenness at presentation to the A&E Department. This commentary offers a review of the scientific foundations on which these recommendations have been made.

Publication types

  • Guideline
  • Practice Guideline
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alcoholism / complications*
  • Diagnosis, Differential
  • Emergency Service, Hospital*
  • Humans
  • Thiamine / administration & dosage
  • Thiamine / therapeutic use*
  • United Kingdom
  • Wernicke Encephalopathy / diagnosis
  • Wernicke Encephalopathy / drug therapy*
  • Wernicke Encephalopathy / etiology
  • Wernicke Encephalopathy / prevention & control


  • Thiamine