Prognosis is dependent on the presentation of the vitamin B1 deficiency and how quickly treatment is instituted. Exact figures regarding recovery and complications are difficult to ascertain as this is a frequently under-diagnosed condition.
Wernicke's encephalopathy
Mortality in acute Wernicke's encephalopathy is estimated to range from 3% to 8%.[11]Rasiah R, Gregoriano C, Mueller B, et al. Hospital outcomes in medical patients with alcohol-related and non-alcohol-related Wernicke encephalopathy. Mayo Clin Proc. 2024 May;99(5):740-53.
https://www.mayoclinicproceedings.org/article/S0025-6196(23)00356-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/38069922?tool=bestpractice.com
[57]Chamorro AJ, Rosón-Hernández B, Medina-García JA, et al. Differences between alcoholic and nonalcoholic patients with Wernicke encephalopathy: a multicenter observational study. Mayo Clin Proc. 2017 Jun;92(6):899-907.
http://www.ncbi.nlm.nih.gov/pubmed/28578781?tool=bestpractice.com
One cohort study estimated 5-year survival to be 68% following diagnosis of Wernicke-Korsakoff's syndrome.[66]Palm A, Vataja R, Talaslahti T, et al. Incidence and mortality of alcohol-related dementia and Wernicke-Korsakoff syndrome: a nationwide register study. Int J Geriatr Psychiatry. 2022 Aug;37(8):10.
https://onlinelibrary.wiley.com/doi/10.1002/gps.5775
http://www.ncbi.nlm.nih.gov/pubmed/35789035?tool=bestpractice.com
Estimates of progression to Korsakoff's psychosis range between 50% and 85%.[67]Arts NJ, Walvoort SJ, Kessels RP. Korsakoff's syndrome: a critical review. Neuropsychiatr Dis Treat. 2017 Nov 27;13:2875-90.
www.doi.org/10.2147/NDT.S130078
http://www.ncbi.nlm.nih.gov/pubmed/29225466?tool=bestpractice.com
Signs and symptoms may be permanent. Of those who develop Korsakoff's psychosis, 25% will require long-term institutional care.[68]van Dam MJ, van Meijel B, Postma A, et al. Health problems and care needs in patients with Korsakoff's syndrome: A systematic review. J Psychiatr Ment Health Nurs. 2020 Aug;27(4):460-481.
https://www.doi.org/10.1111/jpm.12587
http://www.ncbi.nlm.nih.gov/pubmed/31876326?tool=bestpractice.com
Wet beriberi
Untreated, wet beriberi can result in death.[45]Chisolm-Straker M, Cherkas D. Altered and unstable: wet beriberi, a clinical review. J Emerg Med. 2013 Sep;45(3):341-4.
http://www.ncbi.nlm.nih.gov/pubmed/23849362?tool=bestpractice.com
Treatment with parenteral thiamine should result in significant improvement within the first 24 hours of therapy.
Dry beriberi
With thiamine replacement, resolution of symptoms can take weeks to months.[69]Sycks K, Simerlink S, McKnight L, et al. A case of dry beriberi from alcohol use disorder and disordered eating. Subst Abus. 2022;43(1):204-5.
http://www.ncbi.nlm.nih.gov/pubmed/34344284?tool=bestpractice.com
[70]Eghbali F, Bhahdoust M, Sarafraz H, et al. Dry beriberi after sleeve gastrectomy: an undiagnosed case report. Int J Surg Case Rep. 2022 Jul;96:107357.
https://www.sciencedirect.com/science/article/pii/S2210261222006034
http://www.ncbi.nlm.nih.gov/pubmed/35779318?tool=bestpractice.com
[71]Ghosh R, León-Ruiz M, Mondal AS, et al. Polyneuropathy in a pregnant woman with hyperemesis gravidarum: do not forget dry beriberi. Neurol Perspect. 2023 Oct-Dec;3(4):100132.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10732261
http://www.ncbi.nlm.nih.gov/pubmed/38124708?tool=bestpractice.com
In some cases, symptoms may never fully resolve, particularly if there is a co-existing additional cause of neuropathy such as alcohol abuse or diabetes.
Gastrointestinal beriberi
Rapid resolution of gastrointestinal symptoms with high-dose parenteral supplementation of thiamine is seen.[8]Vu TND, Junker MS, Kurjatko A, et al. Gastrointestinal beriberi mimicking a surgical emergency in a well-nourished patient: a case report. Mayo Clin Proc Innov Qual Outcomes. 2019 Dec;3(4):506-9.
https://www.mcpiqojournal.org/article/S2542-4548(19)30113-4/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/31993570?tool=bestpractice.com