| Nutritional deficiencies | Severe malnutrition from famine, poverty, or eating disorders |
| Hyperemesis gravidarum | Prolonged vomiting in pregnancy leading to vitamin deficiencies |
| Bariatric surgery | Weight loss surgery that can cause malabsorption of micronutrients |
| Chronic dialysis | Both hemodialysis and peritoneal dialysis remove water-soluble vitamins |
| Thyroid disorders | Hyperthyroidism increases metabolic demands for thiamine |
| Gastrointestinal diseases | Conditions such as Crohn's disease, celiac disease, or gastric bypass that impair nutrient absorption |
| Chronic diuretic use | Loop diuretics increase thiamine excretion 8 |
| Dorsal medulla lesions | Lesions in the dorsal medulla oblongata affect the nucleus tractus solitarius and the dorsal motor nucleus of the vagus nerve. |
| Periaqueductal gray matter involvement | The periaqueductal region shows similar necrotic changes, often with microhemorrhages. |
| Thalamic lesions | The medial thalamus, particularly the dorsomedial nucleus, is frequently affected, contributing to the memory impairment characteristic of Korsakoff syndrome. |
| Cerebellar involvement | The cerebellar vermis shows degeneration of Purkinje cells and granular layer changes, contributing to the ataxia. |
| Cortical changes | While less prominent than subcortical lesions, cortical neuronal loss and gliosis may be present, particularly in the frontal lobes 11. |
| Databases | OMIMOrphanetClinicalTrialsPubMed |