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Wernicke Encephalopathy

Abin Chandrakumar, Aseem Bhardwaj, Geert W 't Jong
Wernicke encephalopathy (WE) and Korsakoff psychosis (KP), together termed Wernicke-Korsakoff syndrome (WKS), are distinct yet overlapping neuropsychiatric disorders associated with thiamine deficiency. Thiamine pyrophosphate, the biologically active form of thiamine, is essential for multiple biochemical pathways involved in carbohydrate utilization. Both genetic susceptibilities and acquired deficiencies as a result of alcoholic and non-alcoholic factors are associated with thiamine deficiency or its impaired utilization...
October 2, 2018: Journal of Basic and Clinical Physiology and Pharmacology
Vikash Talib, Shazia Sultana, Ahmed Hamad, Uzair Yaqoob
Wernicke's encephalopathy (WE) is a life-threatening acute or sub-acute neurological emergency characterized by ataxia, confusion, nystagmus, and ophthalmoparesis caused by thiamine deficiency. It was first described in 1881 by Carl Wernicke with alcohol being the most common cause. We present a rare case of a 35-year-old pregnant female who presented to our emergency department with a history of vomiting and loose motions for two weeks. She later developed fever, confusion, slurred speech and blurring of vision...
July 17, 2018: Curēus
Hideki Onishi, Mayumi Ishida, Nozomu Uchida, Daisuke Shintani, Tadaaki Nishikawa, Kosei Hasegawa, Keiichi Fujiwara, Tatsuo Akechi
OBJECTIVE: Although thiamine deficiency (TD) and Wernicke encephalopathy (WE) are not rare in cancer patients, the cases reported to date developed TD and/or WE after treatment had started. METHOD: From a series of cancer patients, we report a patient diagnosed with TD without the typical clinical symptoms of WE at the preoperative psychiatric examination.ResultA 43-year-old woman with ovarian cancer was referred by her oncologist to the psycho-oncology outpatient clinic for preoperative psychiatric evaluation...
August 31, 2018: Palliative & Supportive Care
Kazumasa Zensho, Hisashi Ishida, Hiroki Nagai, Hirokazu Tsukahara, Akira Shimada
No abstract text is available yet for this article.
August 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Pradeep Attaluri, Austin Castillo, Hawa Edriss, Kenneth Nugent
Thiamine is an essential cofactor for 4 enzymes involved in the production of energy (ATP) and the synthesis of essential cellular molecules. The total body stores of thiamine are relatively small, and thiamine deficiency can develop in patients secondary to inadequate nutrition, alcohol use disorders, increased urinary excretion and acute metabolic stress. Patients with sepsis are frequently thiamine deficient, and patients undergoing surgical procedures can develop thiamine deficiency. This deficiency can cause congestive heart failure, peripheral neuropathy, Wernicke's encephalopathy, Korsakoff's syndrome and gastrointestinal beriberi...
June 21, 2018: American Journal of the Medical Sciences
Bahattin Tuncalı, Yonca Özvardar Pekcan, Asude Ayhan, Varlık Erol, Tuğba Han Yılmaz, Zeynep Kayhan
Objective: In the present study, we aimed to retrospectively evaluate the preoperative characteristics, intraoperative and postoperative results of patients who underwent laparoscopic obesity surgeries. Methods: After obtaining the approval of the Ethics Committee, records of patients who underwent laparoscopic obesity surgery from January 2013 to December 2016 were reviewed. Demographic characteristics, medications used in anaesthesia and analgesia, the duration of recovery unit/hospital stay, intensive care unit/mechanical ventilation requirements and complications were recorded...
August 2018: Turkish Journal of Anaesthesiology and Reanimation
Sanjay Prakash, Hemant Joshi, Jay Patel
Progressive supranuclear palsy (PSP) may be a risk factor for thiamine deficiency. The classic symptoms of PSP (postural instability, supranuclear vertical gaze palsy and dementia) overlap with the clinical triad of Wernicke's encephalopathy (cognitive impairment, gait problems and ocular abnormality). Therefore, superimposed thiamine deficiency in patients with PSP may aggravate the pre-existing symptoms of PSP. Here, we are reporting a 64-year-old woman having supranuclear ocular palsy, gait instability and dementia for the past 2-3 years...
August 20, 2018: BMJ Case Reports
Lam Mun-Wei, Govindasamy Gayathri, Goh Kwang Hwee, Kanesalingam Ruban, Vasudevan Suresh Kumar, Ismail Shatriah
Wernicke's encephalopathy following severe hyperemesis gravidarum is an uncommon clinical entity. We describe a rare manifestation of optic discs swelling in a pregnant woman that has caused a diagnostic dilemma. With high index of suspicion of clinical manifestations and radiological evidences, a clinical diagnosis of Wernicke's encephalopathy was made. Intravenous thiamine therapy was instituted, and prompt improvement of clinical signs was observed. The association of optic discs swelling and Wernicke's encephalopathy after hyperemesis gravidarum is discussed...
June 12, 2018: Curēus
Christopher L Robinson, Jayshil J Patel
No abstract text is available yet for this article.
August 10, 2018: American Journal of Medicine
Stamatis Karakonstantis, Despoina Galani, Dafni Korela, Sevasti Maragou, Despoina Arna, Maria Basta
BACKGROUND: Wernicke encephalopathy (WE) predominantly occurs in alcoholic patients. Few case reports have described this diagnosis as a result of dieting. The diagnosis is often missed or delayed resulting in permanent and severe neurologic sequelae and even death. The typical neurological signs may be absent or missed during the early stages of thiamine deficiency. Case report; A 23-year-old female presented to the hospital with confusion, bilateral lateral rectus palsy, and ataxia...
August 9, 2018: Nutritional Neuroscience
Hideki Onishi, Mayumi Ishida, Hiroshi Kagamu, Yoshitake Murayama, Kunihiko Kobayashi, Izumi Sato, Nozomu Uchida, Tatsuo Akechi
OBJECTIVE: Wernicke encephalopathy (WE) is a neuropsychiatric disorder caused by thiamine deficiency. It is recognized in various stages of the cancer trajectory but has not previously been recognized during nivolumab treatment. METHOD: From a series of WE patients with cancer, we report a lung cancer patient who developed WE during treatment with nivolumab.ResultA 78-year-old woman with lung cancer was referred to our psycho-oncology clinic because of depressed mood...
August 3, 2018: Palliative & Supportive Care
Elanagan Nagarajan, Chintan Rupareliya, Pradeep C Bollu
Wernicke's encephalopathy (WE) is a rare neurological syndrome that presents in the setting of thiamine deficiency. Though alcoholism is the most common cause of this condition, a few other etiologies include malnutrition from other causes, hemodialysis, and hyperemesis gravidarum. In this case report, we aim to report a case of a young woman who developed WE in the setting of hyperemesis gravidarum (HG) that improved with thiamine replacement. This manuscript details her presentation and clinical examination and includes a spontaneous upbeat nystagmus and goes over the condition along with a review of the literature...
May 9, 2018: Curēus
Aysun Genç, Elif C Özdemir, Esra Moustafa, Ayşe A Küçükdeveci
Wernicke-Korsakoff syndrome is a type of brain disorder caused by the lack of thiamine, most commonly because of chronic alcohol misuse. It consists of two separate conditions including Wernicke's encephalopathy and Korsakoff syndrome. Various levels of cognitive impairments are associated with the severity of the syndrome. Although the effectiveness of thiamine replacement in the early phases of the syndrome is proven, the efficacy of subsequent treatments, which mainly include rehabilitation protocols after the development of Korsakoff syndrome, is not clear...
July 9, 2018: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Erik Oudman, Jan W Wijnia, Misha J Oey, Mirjam J van Dam, Albert Postma
Anorexia nervosa (AN) is a common eating disorder that affects 2.9 million people worldwide. Not eating a balanced diet or fasting can cause neurological complications after severe vitamin B1 malnourishment, although the precise signs and symptoms of Wernicke's encephalopathy (WE) are not clear. Our aim was to review the signs and symptoms of WE in patients with AN. We searched MEDLINE, EMBASE, Scopus, and PiCarta on all case descriptions of WE following AN. All case descriptions of WE in AN, irrespective of language, were included...
October 2018: Psychiatry and Clinical Neurosciences
Sanjay Prakash
Gastrointestinal symptoms, such as anorexia, nausea, vomiting and abdominal pain, are very common in patients with Wernicke's encephalopathy (WE). Mild thiamine deficiency may have only gastrointestinal symptoms. We are reporting two patients with thiamine deficiency who predominantly had gastrointestinal symptoms. Case 1: a 38-year-old man had gastrointestinal problems for about 2-3 years. It gradually became severe. The patient came to the neurology outpatient department for his recent-onset vertigo and headache...
July 6, 2018: BMJ Case Reports
Song Xue, Lei Yuan, Hao-Yu Cheng, Yu-Ming Yin, Jiang-Ying Gu, Wei-Jie Zhang, Jing-Bo Wang
OBJECTIVE: To make through introduction of Wernicke's encephalopathy (WE) following hematopoietic stem cell transplantation (HSCT) in terms of clinical characteristics, diagnostic process and treatment. METHODS: The clinical charactaristics, diagnostic and therapeutic process and prognostic follow-up in 4 patients diagnosed of WE following HSCT between January 2016 to January 2017 at Department of Hematology, Chinese Aerospace Center Hospital were retrospectively analyzed...
June 2018: Zhongguo Shi Yan Xue Ye Xue za Zhi
Georgios Nikolakaros, Timo Kurki, Janina Paju, Sokratis G Papageorgiou, Risto Vataja, Tuula Ilonen
Background: Non-alcoholic Wernicke's encephalopathy and Korsakoff syndrome are greatly underdiagnosed. There are very few reported cases of neuropsychologically documented non-alcoholic Korsakoff syndrome, and diffusion tensor imaging (DTI) data are scarce. Methods: We report clinical characteristics and neuropsychological as well as radiological findings from three psychiatric patients (one woman and two men) with a history of probable undiagnosed non-alcoholic Wernicke's encephalopathy and subsequent chronic memory problems...
2018: Frontiers in Psychiatry
Mario Manto, Gaetano Perrotta
The cerebellum is a brain region which is particularly susceptible to intoxication. Clinical presentation is heterogeneous. It is often considered that elderly patients and patients presenting pre-existing structural lesions of the posterior fossa are particularly at risk of developing a toxic-induced cerebellar syndrome (TOICS). However, TOICS may occur at any age, including in utero. Indeed, the cerebellum is highly vulnerable during neurodevelopment. Amongst cerebellotoxic agents, ethanol is the most commonly implicated...
2018: Handbook of Clinical Neurology
Kalimullah Jan
A 61-year-old gentleman, with a long-standing history of alcohol abuse presented with altered sensorium and unsteady gait for 2 weeks. A diagnosis of Wernicke encephalopathy (WE) was considered. The magnetic resonance imaging brain showed features consistent with the WE, thus supporting the diagnosis. He was treated with parenteral thiamine with good outcome.
May 2018: Oxford Medical Case Reports
Aryo Zare, Ali Jahanshahi, Mohammad-Sajjad Rahnama'i, Sandra Schipper, Gommert A van Koeveringe
The periaqueductal gray matter (PAG), as one of the mostly preserved evolutionary components of the brain, is an axial structure modulating various important functions of the organism, including autonomic, behavioral, pain, and micturition control. It has a critical role in urinary bladder physiology, with respect to storage and voiding of urine. The PAG has a columnar composition and has extensive connections with its cranially and caudally located components of the central nervous system (CNS). The PAG serves as the control tower of the detrusor and sphincter contractions...
May 26, 2018: Molecular Neurobiology
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