scholarly journals MR Imaging Findings in Alcoholic and Nonalcoholic Acute Wernicke’s Encephalopathy: A Review

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Gaetana Manzo ◽  
Angela De Gennaro ◽  
Attilio Cozzolino ◽  
Antonietta Serino ◽  
Giacomo Fenza ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Complex Disease ◽  
Hyperemesis Gravidarum ◽  
Vitamin B1 ◽  
Chronic Alcoholism ◽  
Sudden Onset ◽  
Wernicke’S Encephalopathy ◽  
Wernicke's Encephalopathy ◽  
Tectal Plate ◽  
Low Prevalence

Wernicke’s encephalopathy (WE) is a severe neurological syndrome caused by thiamine (vitamin B1) deficiency and clinically characterized by the sudden onset of mental status changes, ocular abnormalities, and ataxia. Apart from chronic alcoholism, the most common cause of WE, a lot of other conditions causing malnutrition and decreasing thiamine absorption such as gastrointestinal surgical procedures and hyperemesis gravidarum must be considered as predisposing factors. Due to its low prevalence and clinical heterogeneity, WE is often misdiagnosed, leading to persistent dysfunctions and, in some cases, to death. Nowadays, MR imaging of the brain, showing T2 and FLAIR hyperintensities in typical (thalami, mammillary bodies, tectal plate, and periaqueductal area) and atypical areas (cerebellum, cranial nerve nuclei, and cerebral cortex), is surely the most important and effective tool in the diagnostic assessment of WE. The aim of this paper is to propose a state of the art of the role of MR imaging in the early diagnosis of this complex disease.

scholarly journals Wernicke’s encephalopathy: An uncommon complication from hyperemesis gravidarum

2019 ◽  
Vol 13 (4) ◽  
pp. 198-200
Author(s):  
Roshan Shah ◽  
Isabelle Malhamé ◽  
Mariam Fayek ◽  
Alisa Merolli ◽  
Niharika Mehta
Keyword(s):  
Hyperemesis Gravidarum ◽  
Vitamin B1 ◽  
Wernicke’S Encephalopathy ◽  
Nutritional Deficiencies ◽  
Wernicke's Encephalopathy ◽  
Gait Ataxia ◽  
Severe Nausea ◽  
Neurologic Manifestation ◽  
Vitamin B1 Deficiency ◽  
Uncommon Complication

Hyperemesis gravidarum is a complication of pregnancy associated with severe nausea and vomiting that can lead to fluid-electrolyte imbalances and nutritional deficiencies. Wernicke’s encephalopathy is a neurologic manifestation of acute thiamine (vitamin B1) deficiency. We describe a case of hyperemesis gravidarum presenting with gait ataxia and nystagmus which led to a diagnosis of Wernicke’s encephalopathy.

scholarly journals Mild symptomatic Wernicke’s Encephalopathy: a case report

2018 ◽  
Vol 8 (3) ◽  
pp. 197-200
Author(s):  
Maria Sofia Cotelli ◽  
Patrizia Civelli ◽  
Marinella Turla
Keyword(s):  
Hyperemesis Gravidarum ◽  
Active Form ◽  
Vitamin B1 ◽  
Biologically Active ◽  
Wernicke’S Encephalopathy ◽  
Thiamine Pyrophosphate ◽  
Wernicke's Encephalopathy ◽  
Clinical Settings ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Wernicke’s encephalopathy (WE) is an acute, neuropsychiatric syndrome which results from a deficiency in vitamin B1 (thiamine), which in its biologically active form, thiamine pyrophosphate, is an essential coenzyme in several biochemical pathways in the brain, often due to alcohol abuse (alcoholic WE). Non-alcoholic WE variant manifests in many different clinical settings, such as gastrointestinal tumors, hyperemesis gravidarum, chemotherapy, acquired immunodeficiency syndrome, prolonged therapeutic fasting, protracted parenteral nutrition and bariatric surgery, anorexia nervosa and can even be secondary to socioeconomic factors. The classic triad of encephalopathy, oculomotor dysfunction, and gait ataxia is only seen in approximately one-third of patients and is more common in alcoholics; only some of these symptoms are usually present. Here we describe a case of an occasional neuroradiological finding of Wernicke Encephalopathy not related to symptoms or signs.

Wernicke’s encephalopathy

2017 ◽  
Vol 10 (11) ◽  
pp. 660-666
Author(s):  
Sue May Liow
Keyword(s):  
Sulfuric Acid ◽  
Late Complication ◽  
Vitamin B1 ◽  
Memory Loss ◽  
Altered Mental Status ◽  
Chronic Alcoholism ◽  
Wernicke’S Encephalopathy ◽  
Wernicke's Encephalopathy ◽  
Common Presentation ◽  
Vitamin B1 Deficiency

Wernicke’s encephalopathy occurs as a result of thiamine (vitamin B1) deficiency. It was originally described by German neurologist Karl Wernicke in 1881 who observed the three cardinal features of Wernicke’s in two men with chronic alcoholism and a young woman who had ingested sulfuric acid and suffered prolonged episodes of vomiting. The three cardinal features are ophthalmoplegia, ataxia and confusion. It is largely undiagnosed, due to its vague presentation. Patients often present with confusion or altered mental status; a common presentation in those who might be intoxicated. The classic triad of symptoms described in textbooks is rarely seen. If not promptly or adequately treated Korsakoff’s syndrome, a late complication can develop, resulting in memory loss, confabulation and, ultimately, death.

scholarly journals Development of Wernicke’s encephalopathy long after subtotal stomach-preserving pancreatoduodenectomy: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Chikanori Tsutsumi ◽  
Toshiya Abe ◽  
Tomohiko Shinkawa ◽  
Hideyuki Watanabe ◽  
Kazuyoshi Nishihara ◽  
...  
Keyword(s):  
Short Term Memory ◽  
Chronic Alcoholism ◽  
Ampulla Of Vater ◽  
Wernicke’S Encephalopathy ◽  
Wernicke's Encephalopathy ◽  
Post Surgery ◽  
Level Of Consciousness ◽  
Fluid Attenuated Inversion Recovery ◽  
After Effect ◽  
Thiamine Level

Abstract Background Wernicke’s encephalopathy (WE) is an acute neuropsychiatric disorder resulting from thiamine (vitamin B1) deficiency, frequently associated with chronic alcoholism and total parenteral nutrition without thiamine. However, only a few reports have focused on the relationship between WE and subtotal stomach-preserving pancreatoduodenectomy (SSPPD). Case presentation A 71-year-old woman underwent SSPPD for an adenocarcinoma of the ampulla of Vater. Although there had been no evidence of recurrence, the patient was treated with antibiotics for cholangitis at 12 and 31 months, respectively, post-surgery. Thereafter, the patient presented with vomiting and disorientation 33 months after surgery. Although she was admitted and underwent closer inspection by a neurologist and a psychiatrist, the exact cause of these syndromes remained unknown. The psychiatrist measured thiamine concentration to examine the cause of disorientation. After 6 days, her level of consciousness worsened. Magnetic resonance imaging of the head showed symmetrically multiple abnormal hyperintense signals on fluid-attenuated inversion-recovery and diffusion weighted image, compatible with WE. An administration of intravenous thiamine was immediately initiated. After 8 days of the measurement of the thiamine level, the patient’s serum thiamine level was found to be 6 µg/mL (reference range, 24–66 µg/mL). Accordingly, the patient was diagnosed with WE. Shortly after starting the treatment, blood thiamine value reached above normal range with significant improvement of her confusional state. However, short-term memory and ataxia remained. Conclusions Development of WE after SSPPD is uncommon. However, to prevent an after-effect, the possibility of development of WE after SSPPD should be recognized.

scholarly journals Total parenteral nutrition-induced Wernicke’s encephalopathy after oncologic gastrointestinal surgery

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 709-713
Author(s):  
Piergiorgio Fedeli ◽  
Richard Justin Davies ◽  
Roberto Cirocchi ◽  
Georgi Popivanov ◽  
Paolo Bruzzone ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Gastrointestinal Surgery ◽  
Vitamin B1 ◽  
Wernicke’S Encephalopathy ◽  
Wernicke's Encephalopathy ◽  
Vitamin Intake ◽  
Unbalanced Diet ◽  
Prolonged Hospital ◽  
Care Costs

AbstractCarl Wernicke described the disease bearing his name in 1881 and reported three cases characterized by the presence of mental confusion, ataxia, and ophthalmoplegia. Wernicke’s disease is mainly observed in alcoholic patients, due to decreased vitamin intake as a consequence of an unbalanced diet, and a reduction of absorption due to the effects of alcohol. Likewise, inadequate vitamin intake is prevalent in older patients. Wernicke’s encephalopathy due to inappropriate total parenteral nutrition (TPN) occurs infrequently; recently, there is an increase in the literature concerning Wernicke’s encephalopathy in patients after general and bariatric surgeries. We present two cases of Wernicke’s encephalopathy after oncologic gastrointestinal surgery by failure to administer vitamin B1 during TPN; to our knowledge, these are the first two cases of Wernicke’s encephalopathy after colorectal surgery for cancer. In our opinion, timely diagnosis and treatment are mandatory to avoid nonfunctional recovery and consequent malpractice legal actions as well as an increase in the health-care costs correlated with the prolonged hospital stay and with the nonfunctional recovery.

Wernicke’s encephalopathy in women with hyperemesis gravidarum – Case series and literature review

2021 ◽  
pp. 004947552110143
Author(s):  
Makarand Anil Rane ◽  
Hari Kishan Boorugu ◽  
Usha Ravishankar ◽  
S Tarakeswari ◽  
Hemamalini Vadlamani ◽  
...  
Keyword(s):  
Hyperemesis Gravidarum ◽  
Rare Complication ◽  
Case Series ◽  
Wernicke’S Encephalopathy ◽  
Wernicke's Encephalopathy ◽  
Chronic Alcohol Abuse ◽  
Delayed Treatment ◽  
Altered Mental State ◽  
Short And Long Term ◽  
Clinical Triad

Whilst nausea affects around 80% of pregnant women, hyperemesis gravidarum, an extreme form of the same, affects only 0.5% to 3%, but may lead to severe nutritional deficiency. Wernicke’s encephalopathy is an acute neuropsychiatric disorder which occurs due to thiamine deficiency and needs emergency treatment to prevent neurological morbidity and mortality. Wernicke’s encephalopathy is characterised by a clinical triad of oculomotor abnormalities, cerebellar dysfunction and altered mental state. Korsakoff’s psychosis is a chronic condition and consequence of Wernicke’s encephalopathy, resulting from its delayed treatment. Wernicke’s encephalopathy is a well-known complication of chronic alcohol abuse. Not many are aware of its association with hyperemesis gravidarum. Although it is a rare complication, if not diagnosed and treated promptly, it may result in permanent and irreversible neurological sequelae. The objective of our retrospective observational study was to analyse the clinical profile and outcome (short and long term) in a rare yet preventable complication of pregnancy.

Wernicke’s encephalopathy post hyperemesis gravidarum misdiagnosed as Guillain-Barre syndrome: lessons for the frontline

2021 ◽  
Vol 14 (3) ◽  
pp. e239977
Author(s):  
Kaushiki Kirty ◽  
Yashendu Sarda ◽  
Annu Jacob ◽  
Delanthabettu Venugopala
Keyword(s):  
Pregnant Woman ◽  
Hyperemesis Gravidarum ◽  
Early Recognition ◽  
Wernicke’S Encephalopathy ◽  
Guillain Barre Syndrome ◽  
Neurological Deficits ◽  
Wernicke's Encephalopathy ◽  
Motor Neuropathy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

We report a case of a 26-year-old pregnant woman, who presented with subacute limb weakness. This was initially suspected to be Guillain-Barre syndrome but subsequently found to be the motor neuropathy of dry beriberi (vitamin B1, thiamine deficiency) along with associated Wernicke’s encephalopathy (WE). The underlying cause was revealed as hyperemesis gravidarum (HG). HG complicates up to 3% of pregnancies and if severe, without nutritional supplements, may lead to electrolyte disturbances, calorie loss and vitamin deficiency. Although the association of HG and WE was first reported in 1939, it remains an under diagnosed condition with potential for serious and permanent neurological deficits, and some mortality, in both mother and baby. Early recognition of the problem, with timely and careful fluid, electrolyte, glucose and vitamin replacement is needed to avoid complications. We highlight current best practice in the treatment of WE. An open mind to the possibility of HG complications in any pregnant woman presenting with neurological symptoms is probably the most important lesson to learn from the front line.

Sign in / Sign up

Export Citation Format

Share Document