We report the clinical observation of a 46 years old woman developing Wernicke encephalopathy with an atypical presentation, which is complicated by severe dysautonomic syndrome with paralytic ileus, a rarely described complication. Moreover, the patient's Coca-Cola® addictive behaviour highlights the importance of considering the multifactorial origin of thiamine deficiency. Identifying the risk population and recognizing the symptoms in time is essential to avoid a diagnostic delay, potentially fatal, and can lead to a more efficient care management. All rights reserved, Elsevier.

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