Şerife ÖZDİNÇ, Hayri DEMİRBAŞ, Elif YILDIRIM

A Case Report: Non-Alcoholic Wernicke Encephalopathy

Wernicke encephalopathy (WE) is a life-threatening neurological illness caused by thiamine deficiency. Chronic alcoholism is one of the most important cause of WE, however, WE may develop in other conditions, such as severe malnutrition, hyperemesis gravidarum, prolonged parenteral nutrition, malignancies, bariatric surgery. WE is presenting with classical findings of cerebellar, ocular and confusion. Diagnosis of WE is usually made by history and physical examination. The aim of the treatment is the rapid correction of thiamine deficiency. In this report, we present a patient who with WE had gastrointestinal tract diseases and had undergone gastrointestinal surgeries and discuss predisposing factors as well as diagnostic and therapeutic issues related to this entity.

Keywords:

Wernicke encephalopathy, thiamine, delirium gait ataxia, gastrointestinal tract diseases, emergency room,

PDF

___

Referans1 Tang L, Alsulaim HA, Canner JK, Prokopowicz GP, Steele KE. Prevalence and predictors of postoperative thiamine deficiency after vertical sleeve gastrectomy. Surg Obes Relat Dis. 2018 Jul;14(7):943-950. doi: 10.1016/j.soard.2018.03.024.
Referans2 Vasan S, Kumar A. Wernicke Encephalopathy. [Updated 2018 Nov 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK470344/
Referans3 Galvin R, Bråthen G, Ivashynka A, Hillbom M, Tanasescu R, Leone MA EFNS. EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. Eur J Neurol. 2010 Dec;17(12):1408-18. doi: 10.1111/j.1468-1331.2010.03153.x.
Referans4 Donnino MW, Vega J, Miller J, Walsh M. Myths and misconceptions of Wernicke's encephalopathy: what every emergency physician should know. Ann Emerg Med. 2007 Dec;50(6):715-21.
Referans5 Antunez E, Estruch R, Cardenal C, Nicolas JM, Fernandez-Sola J, Urbano-Marquez A. Usefulness of CT and MR imaging in the diagnosis of acute Wernicke's encephalopathy. AJR Am J Roentgenol. 1998 Oct;171(4):1131-7.
Referans6 Kim WJ, Kim MM. Wernicke's Encephalopathy Presenting with Bilateral Complete Horizontal and Downward Gaze Palsy in a Malnourished Patient. Korean J Ophthalmol. 2017 Aug;31(4):372-374. doi: 10.3341/kjo.2017.0014.
Referans7 Donnino MW, Miller J, Garcia AJ, McKee E, Walsh M.. Distinctive acid-base pattern in Wernicke's encephalopathy. Ann Emerg Med. 2007 Dec;50(6):722-5.
Referans8 Fattal-Valevski A, Kesler A, Sela BA, Nitzan-Kaluski D, Rotstein M, Mesterman R, et al. Outbreak of life-threatening thiamine deficiency in infants in Israel caused by a defective soy-based formula. Pediatrics. 2005 Feb;115(2):e233-8.
Referans9 Azim W, Walker R. Wernicke's encephalopathy: a frequently missed problem. Hosp Med. 2003 Jun;64(6):326-7.
Referans10 Day E, Bentham PW, Callaghan R, Kuruvilla T, George S. Thiamine for prevention and treatment of Wernicke- Korsakoff Syndrome in people who abuse alcohol. Cochrane Database Syst Rev. 2013 Jul 1;(7):CD004033. doi: 10.1002/14651858.CD004033.pub3.