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.

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.

Wernicke's encephalopathy in two patients with acquired immunodeficiency syndrome

1990 ◽  
Vol 237 (7) ◽  
pp. 445-447 ◽  
Author(s):  
J. Schwenk ◽  
G. Gosztonyi ◽  
P. Thierauf ◽  
J. Iglesias ◽  
E. Langer
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
Wernicke’S Encephalopathy ◽  
Wernicke's Encephalopathy ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

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 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.

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