B – 68 Neuropsychological Dimensions of Non-Alcoholic Wernicke’s Encephalopathy With Co-occurring Diabetes Mellitus and Psychiatric Behaviors: A Case Study of a Young Adult in Acute Rehabilitation

Abstract Objective Wernicke’s Encephalopathy (WE) is a severe neurological disorder resulting from severe thiamine deficiency, characterized by a triad of symptoms: eye movement disorders, altered mental status, and ataxia. While primarily associated with alcohol misuse, non-alcoholic cases are on the rise. This study examines the neuropsychological impairments of a young woman diagnosed with non-alcoholic WE. Uncontrolled diabetes and psychiatric disorders, including trichotillomania, trichophagia, excoriation disorders, and binge-restrict eating behaviors further complicated her neuropsychological profile. A transdisciplinary approach facilitated significant improvements in cognitive functions, anxiety management, and overall functional ability. Method A 21-year-old female presented with severe ambulation, mobility, and cognitive impairments following diabetic ketoacidosis and WE. Neuroimaging revealed bilateral mammillary body enhancement corroborated by markedly low thiamine levels. Complications included peripheral neuropathy, malnutrition, and a large trichobezoar which was surgically removed. Neuropsychological assessments evaluated memory, executive functioning, processing speed, visual scanning, and language through various standardized tests, mood questionnaires, and observations in functional settings. Results Assessments indicated moderate cognitive deficits in immediate and delayed memory, executive function, processing speed, auditory comprehension, and attention, alongside automatic-type obsessive-compulsive behaviors and binge-eating tendencies. Memory impairments aligned with WE-associated deficits. The patient initially required maximum assistance for mobility. The neuropsychological evaluations informed individualized rehabilitation strategies. Conclusion This case highlights severe cognitive (memory, executive functions) and psychological impairments, including diminished insight, in non-alcoholic WE. Neuropsychological assessment during inpatient rehabilitation was critical for guiding transdisciplinary treatment and informing functional decisions, such as returning to college.