Wernicke's Encephalopathy Induced by Tolazamide

THE Wernicke–Korsakoff syndrome is a nutritional neurologic disorder that is due to thiamine deficiency. Although Wernicke's encephalopathy represents the acute phase of the syndrome, Korsakoff's psychosis represents its chronic continuum. Thiamine is a cofactor in glucose metabolism in the glycolytic and pentose phosphate pathways, and a state of thiamine deficiency is well known to be exacerbated or even precipitated by the administration of a glucose load in the patient with marginal thiamine reserves.1 , 2 The correction of hyperglycemia by hypoglycemic agents in diabetic patients increases short-term use of glucose in the tissues, which results in an obligatory demand for more thiamine. . . .