Administration of thiamine in alcohol withdrawal is intended to prevent which complication?

• A. Delirium tremens
• B. Korsakoff or Wernicke's encephalopathy
• C. Liver cirrhosis
• D. Peripheral neuropathy

Answer: (B)

Thiamine during alcohol withdrawal is given to prevent brain damage from thiamine deficiency, specifically Wernicke’s encephalopathy and its progression to Korsakoff syndrome. Chronic alcohol use often leads to poor intake and absorption of vitamin B1, depleting stores. Without thiamine, brain energy production falters because thiamine is a key cofactor for enzymes in glucose metabolism. This energy failure damages regions like the mammillary bodies and thalamus, producing the acute signs of Wernicke’s encephalopathy (confusion, ataxia, eye movement problems) and, if unchecked, the chronic memory disorder of Korsakoff syndrome (severe amnesia and confabulation). Providing thiamine early helps prevent these complications, and it’s commonly given before glucose administration to avoid precipitating or worsening encephalopathy.

Delirium tremens, another withdrawal complication, is managed with supportive care and medications rather than thiamine alone. Liver cirrhosis reflects chronic liver injury rather than a deficiency-related brain complication, and peripheral neuropathy, while it can be associated with thiamine deficiency, is not the primary target of thiamine administration in the withdrawal context.