Wernicke-Korsakoff syndrome (WKS) is a disorder of the brain caused by a deficiency of vitamin B1 (thiamine). It is characterised by an acute onset of some or all of an eye movement disorder, lack of voluntary coordination of muscle movement (ataxia) and confusion. Patients may die in the acute phase, and many survivors go on to develop permanent memory impairment. Alcohol abuse is an important cause of WKS, although it is not the only consideration. Heavy drinking may lead to particular problems with uptake of thiamine from the diet.

When recognised, WKS is treated with thiamine, but it is not clear how effective this is, particularly in managing the mental features. Recommendations about dosage and duration of thiamine treatment are acknowledged to be arbitrary. We searched for randomised controlled trials comparing thiamine with placebo or alternative treatments, or comparing different thiamine treatments. Two studies were identified that met the inclusion criteria, but one reported no data that we could analyse, and analysis of the other study was limited by shortcomings in design and in presentation of the results. Therefore no good evidence could be derived from randomised controlled clinical trials to help physicians choose the right dose, frequency, route or duration of thiamine treatment for preventing or treating WKS due to alcohol abuse.