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Wernicke Encephalopathy

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...
July 8, 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
Liyang Tang, Hatim A Alsulaim, Joseph K Canner, Gregory P Prokopowicz, Kimberley E Steele
BACKGROUND: As the vertical sleeve gastrectomy (VSG) becomes increasingly popular, its effect on postoperative micronutrient levels, such as thiamine, becomes more important. We previously found a 1.8% prevalence of thiamine deficiency in bariatric patients before surgery. OBJECTIVE: The aims of this study were to determine the prevalence of thiamine deficiency at our center after VSG and to explore possible predictors of postoperative thiamine levels. SETTING: University hospital, United States...
March 26, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Justin M Johnson, Valerie Fox
BACKGROUND: Wernicke's encephalopathy is a condition whose treatment many consultation-liaison psychiatrists know quite well. Less clear, however, is the treatment of its dementia disorder descendent, the Korsakoff's syndrome (KS). OBJECTIVE: This article seeks to review treatment options and provide recommendations for consultation-liaison psychiatrists treating cognitive impairment in KS. METHODS: In this nonsystematic review, we reviewed PubMed, CINAHL Plus, and Google Scholar for published reports and studies regarding treatment of KS...
July 2018: Psychosomatics
Hideki Onishi, Mayumi Ishida, Takao Takahashi, Yoshitada Taji, Kenji Ikebuchi, Daisuke Furuya, Nozomu Uchida, Tatsuo Akechi
OBJECTIVE: Wernicke encephalopathy (WE) is a neuropsychiatric disorder caused by thiamine deficiency, and is sometimes overlooked because of the diversity of clinical symptoms. METHOD: From a series of WE patients with cancer, we report a lung cancer patient who developed WE, the main symptom of which was agitation.ResultA 50-year-old woman with lung cancer was referred to our psycho-oncology clinic because of agitation lasting for three days. No laboratory findings or drugs explaining her agitation were identified...
May 11, 2018: Palliative & Supportive Care
Luke Chen, G Michael Halmagyi
Bilateral vestibulopathy (BVP), which is due to peripheral lesions, may selectively involve certain semicircular canal (SCC). Recent eye movement recordings with search coil and video head impulse test (HIT) have provided insight in central lesions that can cause bilateral and selective SCC deficit mimicking BVP. Since neurological signs or ocular motor deficits maybe subtle or absent, it is critical to recognize central lesions correctly since there is prognostic and treatment implication. Acute floccular lesions cause bilateral horizontal SCC (HC) impairment while leaving vertical SCC function unaffected...
2018: Frontiers in Neurology
Leslie A Hamilton, Sarah H Darby, Allan J Hamilton, Matthew H Wilkerson, Kabel A Morgan
BACKGROUND: We report a case of a patient who was 3 months post-sleeve gastrectomy and presented with acute stroke symptoms ultimately due to Wernicke's encephalopathy (WE) after bariatric surgery. A 20-year-old white female presented to an outside hospital 3 months after sleeve gastrectomy complaining of nausea and vomiting. She initially underwent a cholecystectomy and later became less responsive and required intubation. Magnetic resonance imaging changes, presumed to be an acute stroke, prompted her transfer to our facility...
August 2018: Nutrition in Clinical Practice
Rita Moretti, Paola Caruso, Matteo Dal Ben, Silvia Gazzin, Claudio Tiribelli
BACKGROUND: Drinking more than the recommended limits is a worldwide emerging problem, difficult to circumscribe, and alcohol-related brain damages are an under-recognized health problem. Alcohol-cognitive disruption can be considered as transient and recoverable if the alcohol consumption is limited and occasional; if not, it can progress to the so-called Alcohol-Related Dementia (ARD), or to the Wernicke encephalopathy, or it can even induce the Korsakoff syndrome, an irreversible and long-lasting medical condition...
2017: Current Drug Abuse Reviews
G Martines, N Musa, F Aquilino, P Capuano
AIM: In the last years with the increase of bariatric surgery, first of all as a result of new indications, a rise in the incidence of nutrient-related complications has been observed. Currently little is known about the impact of post-bariatric malnutrition and neurological complications. Wernicke's encephalopathy is a severe neurological syndrome which occurs as a result of thiamine deficiency. Wernicke-Korsakoff syndrome must be considered a serious neurological complication of bariatric surgery with significant morbidity and mortality, with rapidly progressing neurological symptoms, and must be treated immediately...
March 2018: Il Giornale di Chirurgia
Erik Oudman, Jan W Wijnia, Mirjam van Dam, Laser Ulas Biter, Albert Postma
Half a million bariatric procedures are performed annually worldwide. Our aim was to review the signs and symptoms of Wernicke's encephalopathy (WE) after bariatric surgery. We included 118 WE cases. Descriptions involved gastric bypass (52%), but also newer procedures like the gastric sleeve. Bariatric WE patients were younger (median = 33 years) than those in a recent meta-analysis of medical procedures (mean = 39.5 years), and often presented with vomiting (87.3%), ataxia (84.7%), altered mental status (76...
July 2018: Obesity Surgery
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