**Question:** All the following features are seen in Wernicke's encephalopathy except

A. Korsakoff's psychosis
B. Diabetes insipidus
C. Cranial nerve palsies
D. Seizures

**Core Concept:**
Wernicke's encephalopathy is a neurological complication of thiamine deficiency, most commonly seen in alcoholics who consume large amounts of carbohydrate-rich foods lacking thiamine (vitamin B1). Thiamine is essential for maintaining the integrity of neuronal membranes, particularly in the brainstem and cerebellum. Thiamine deficiency leads to the disruption of cellular energy production and impaired glucose utilization, leading to characteristic brain lesions and symptoms.

**Why the Correct Answer is Right:**
Wikipedia mentions that Korsakoff's psychosis is a neuropsychological syndrome that develops as a complication of Wernicke's encephalopathy. It is characterized by memory loss, confabulation (invention of false memories), and intellectual impairment. Korsakoff's psychosis develops later than Wernicke's encephalopathy and is not a direct consequence of thiamine deficiency.

**Why Each Wrong Option is Incorrect:**

**A. Diabetes insipidus:** Diabetes insipidus is a condition characterized by excessive urine production due to impaired secretion of antidiuretic hormone (ADH) or vasopressin. This is a separate condition caused by disorders of the hypothalamus or pituitary gland, distinct from Wernicke's encephalopathy.

**B. Cranial nerve palsies:** Cranial nerve palsies are a group of disorders affecting different cranial nerves. While some cases of Wernicke's encephalopathy may present with cranial nerve palsies, they are not a direct consequence of thiamine deficiency.

**C. Seizures:** Although seizures can be seen in Wernicke's encephalopathy due to widespread brain dysfunction, they are not specific to the condition. Seizures can occur with various neurological conditions and are not unique to thiamine deficiency.

**D. Thiamine deficiency:** The question does not specify that seizures are a consequence of thiamine deficiency. Seizures can be seen in Wernicke's encephalopathy but are not exclusive to thiamine deficiency.

**Clinical Pearls:**
1. Wernicke's encephalopathy is characterized by the triad of:
- Ophthalmoplegia (involuntary eye movements and/or gaze palsies)
- Confusion
- Korsakoff's psychosis

2. Korsakoff's psychosis is a neuropsychological disorder resulting from Wernicke's encephalopathy. It involves memory loss, disorientation, and confabulation (invention of false memories).

3. Diagnosis of Wernicke's encephalopathy is made based on a combination of clinical findings, including the triad mentioned above, and supportive laboratory tests (low serum thiamine levels, elevated blood glucose levels,