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About 82 percent of patients with WE present with delirium according to autopsy-based series.[32] This constellation of symptoms is largely due to involvement of thalamic or mamillary bodies and range from a confusional state to mental sluggishness, apathy, impaired awareness of the immediate situation, inability to concentrate and, if left untreated, coma and death.[32,50] Some patients may present with confusion or agitation, hallucinations, and behavioral disturbances that mimic an acute psychotic disorder.[51,52] Ocular abnormalities occur in approximately 29 pecent of patients, and include nystagmus, symmetrical or asymmetrical palsy of either lateral recti or other ocular muscles, and conjugate-gaze palsies, which result from lesions of the pontine tegmentum and of the abducens and oculomotor nuclei.[53] Acute WE, if left untreated, leads to the more profound, debilitating, global amnesic condition of Korsakoffs psychosis (KS),[54] although WE does not necessarily evolve into KS if adequately treated.[11,33] It remains controversial whether KS can develop without WE and whether mild forms of neuropsychological sequelae arise from repeated bouts of thiamine deficiency or inadequate treatment of such episodes

H., Espevik T., Ryan L., Stokke B