Wernicke-Korsakoff (W-K) syndrome is a neuropsychiatric disorder resulting from thiamine deficiency, which is associated with significant morbidity and mortality. According to autopsy-based studies, it is still greatly underdiagnosed. In this case study and review, we focus on late diagnosed W-K related with alcohol misuse, and we give a short review about the topic focusing on its prompt diagnosis and adequate treatment.

We intend to underline that W-K syndrome, a preventable neurological condition and even treatable in its early phase if suspected, is underdiagnosed, with critical consequences for the patient's prognosis.

Using a case-report format, we describe three cases of W-K syndrome which were initially misdiagnosed in different general hospitals. We summarize complementary explorations, therapeutic management and evolution, and after that we shortly review the topic.

The three patients were diagnosed of W-K syndrome in the psychiatry unit, weeks after being visited in the emergency facilities, where it was not suspected nor detected or prevented. All of them ended up with cognitive disabilities of a different degree, always with a remarkable impact in their functioning. One of them achieved some amelioration with thiamine in high doses, despite its late detection.

W-K can be prevented and treated if early detected, but it is underdiagnosed, with severe consequences for the patients. We suggest some measures that could enhance its detection and prevention, like modifying emergency room protocols, both diagnostic and therapeutic.