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Comment & Response
September 8, 2020

Challenges in Prediction and Diagnosis of Alcohol Withdrawal Syndrome and Wernicke Encephalopathy

Author Affiliations
  • 1Unit of Clinical Neurology, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
JAMA Intern Med. Published online September 8, 2020. doi:10.1001/jamainternmed.2020.3558

To the Editor Alcohol withdrawal syndrome (AWS) and Wernicke encephalopathy (WE) are medical emergencies associated with considerable morbidity and mortality, and are still greatly underdiagnosed and misdiagnosed in clinical practice, either in primary or in secondary care.1,2 The best aid for diagnosis in both diseases, particularly in individuals with chronic alcohol misuse, is a detailed medical history. In particular, an accurate understanding of the natural history of alcohol withdrawal, including the temporal progression of neurological signs, is essential for a diagnosis of AWS, while an intelligent search for any factor potentially responsible for an insufficient supply of thiamine is essential for diagnosis of WE.1,2

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