There are no specific signs for Beriberi. Therefore, it should be suspected in light of the patient’s symptoms and clinical setting. However, in advanced stages, the signs of cardiac dysfunction (wet beriberi) or peripheral neuropathy (dry beriberi) may be present. In Wernicke-Korsakoff syndrome patients, the triad of nystagmus, ophthalmoplegia, and ataxia may be present.

Beriberi itself has no specific examination signs. In advanced stages, the signs of related complications as cardiac dysfunction or peripheral neuritis are present. Therefore, for earlier diagnosis of Beriberi, clinical sense in light of the clinical setting and patient symptoms is required.^[1][2][3][4] The examination signs in advanced stages of beriberi may include:

• Patients with beriberi usually appear normal in early stages.
• But in late stages, the general appearances of cachexia and heart failure kick in.

• Tachycardia with regular pulse
• Tachypnea / bradypnea
• Normal/low blood pressure

• Cyanosis

• Nystagmus (WKS)
• Ophthalmoplegia (WKS)

• Jugular venous distension

• Fine crackles upon auscultation of the lungs bilaterally
• Wheezing may be present

• Gallops
• Shift in the heart apex (enlarged cardiac chambers)
• A high/low grade early/late systolic murmur / diastolic murmur best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the stethoscope

• Hepatomegaly

• Back examination of patients with beriberi is usually normal

• Genitourinary examination of patients with beriberi is usually normal

• Altered mental status
• Ataxia
• Amnesia (WKS)
• Altered deep tendon reflexes
• Muscle weakness bilaterally
• Bilateral upper and lower extremities weakness
• Bilateral sensory loss in the upper and lower extremities (Dry beriberi)

• Cyanosis
• Pitting/non-pitting edema of the upper/lower extremities
• Muscle atrophy
• Wrist and ankle drop in advanced stages.

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