Yin H, Xu Q, Cao Y, Qi Y, Yu T, Lu W. Nonalcoholic Wernicke's encephalopathy: a retrospective study of 17 cases.
J Int Med Res 2019;
47:4886-4894. [PMID:
31502510 PMCID:
PMC6833415 DOI:
10.1177/0300060519870951]
[Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objective
Nonalcoholic Wernicke’s encephalopathy (WE) is a devastating
neuropsychiatric syndrome caused by thiamine deficiency.
Although many case reports on WE have been published, more
studies are required to guide the diagnosis and treatment of
nonalcoholic WE.
Methods
We retrospectively studied patients who were diagnosed with WE in
our hospital. Data on demographics, possible causes,
phenomenology, and diagnostic and treatment delays were
abstracted from medical records by chart reviews.
Results
Seventeen patients were diagnosed with nonalcoholic WE.
Nonalcoholic WE had many causes, such as gastrointestinal
surgery, gastrointestinal tract diseases, vomiting, and
psychiatric diseases. Most patients presented with abnormal
mental symptoms, including those in a coma.
Conclusion
In summary, we recommend using operational criteria to diagnose and
treat nonalcoholic WE as early as possible to avoid misdiagnosis
and treatment delays. Nonalcoholic WE remains a clinical
diagnosis, and certain examinations are helpful for this
diagnosis, such as measuring serum thiamine concentrations. We
should focus on patients who present with abnormal mental
symptoms, even those in a coma, and administer parenteral
thiamine before any carbohydrate to reduce the high frequency of
residual morbidity.
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