- Examination of the nervous/muscular system may show polyneuropathy (damage to multiple nerve systems).
- Reflexes may be decreased (or of abnormal intensity), or abnormal reflexes may be present.
- Testing of gait and coordination indicates damage to portions of the brain that control muscle coordination.
- Muscles may be weak and may show atrophy (loss of tissue mass).
- Examination of the eyes shows abnormalities of eye movement.
- Blood pressure and body temperature measurement may be low.
- Pulse (heart rate) may be rapid.
The person may appear cachectic (malnourished). A nutritional assessment may confirm malnourished state. - Serum B1 levels may be low.
- Pyruvate is elevated.
- Transketolase activity is decreased.
If the history is significant for chronicalcohol abuse, serum or urine alcohol levels may be elevated (see toxicology screen) and liver enzymes may be elevated. Other chronic conditions that may cause a thiamine deficiency include the following: - AIDS
- Hyperemesis gravidarum (continuous nausea and vomiting during pregnancy)
- Thyrotoxicosis (very high thyroid hormone levels)
- Cancers that have spread throughout the body
- Long-term dialysis
- Congestive heart failure, when treated with long-term diuretic therapy
A brain MRI rarely shows changes in the tissue of the brain indicating Wernicke-Korsakoff syndrome.
| 
