Background: Up to 12% of hospitalized patients require high dose parenteral thiamine treatment to prevent Wernicke’s Encephalopathy, a devastating and easily preventable neurologic disorder that can lead to death. Despite the fact that it is as simple and relatively inexpensive therapy with no known side effects, high dose thiamine continues to be underutilized. Attempts to […]

Case Presentation: 74-year-old male with history of NASH cirrhosis with Grade I esophageal variceal bleeding history, SDH s/p burr hole drainage with course complicated by seizures on Keppra and Vimpat, type 2 diabetes mellitus, and coronary artery disease status post 1 drug eluting stent who presented with worsening confusion, fatigue and difficulty walking x 3-4 […]

Case Presentation: This is a case of a 53 year old female with past medical history of hypertension, anxiety and gastric bypass surgery in 2001. She presented to the hospital acutely ill, complaining of inability to ambulate along with leg weakness that had started two years ago and was associated with progressive numbness and tingling. […]

Case Presentation: A 23 year-old woman presented with blurry vision and difficulty walking for two weeks. Her family also reported two weeks of progressive memory changes and a 52-pound weight loss over four months. One month prior to presentation, while pregnant at 18 weeks gestation, she was admitted with three months of vomiting and five […]

Case Presentation: A 29 year old female presents with one week of sudden onset double vision. She reports accompanying dark spots in her vision, photosensitivity, and some unsteadiness with walking. The patient’s friend noted that her eyes were “crossed” the morning of admission. Past medical history is significant for alcohol abuse and anxiety with a […]

Case Presentation: A 44 year-old woman presented with light-headedness and numbness and tingling in her hands and feet. Her past medical history included gastric reflux with hiatal hernia and Roux-en-Y bypass with hernia repair 11 weeks prior to admission, complicated by a post-operative esophageal stricture. She reported difficulty maintaining oral intake for the three weeks […]