Himel Kumar Biswas, Monisha Basak, Mosarrat Mahjabeen, Nazia Ahmed, Rama Biswas
A 40-year-old female with no history of alcohol use presented with altered mental status and generalized weakness ten days after dilation and curettage for missed abortion, complicated by persistent vomiting and electrolyte imbalances. Examination revealed confusion and disorientation, without nystagmus, ophthalmoplegia, or ataxia. Brain MRI showed characteristic symmetrical periventricular signal abnormalities consistent with Wernicke's encephalopathy. She was treated with intravenous thiamine (500 mg three times daily for five days), followed by oral supplementation, with gradual resolution of confusion. She was discharged on the 13th hospital day in a hemodynamically and neurologically stable condition. This case highlights that nonalcoholic Wernicke's encephalopathy can occur following surgical procedures complicated by prolonged vomiting and nutritional deficits. Early recognition and prompt thiamine replacement are essential for favorable outcomes.