A case report of Wernicke's encephalopathy in a pediatric patient with anorexia nervosa--restricting type.
OBJECTIVE
To describe a case of Wernicke's encephalopathy in a 15-year-old female patient with anorexia nervosa--restricting type.


METHODS
The patient and family were interviewed. Literature relevant to the case was reviewed prior to diagnosis.


RESULTS
The patient reported a 30-kg weight loss over a 6-month period, following a strict diet deplete in thiamine without vitamin supplementation. The patient reported a carbohydrate binge for 5 days prior to admission. Her clinical presentation, confusion, ataxia, nystagmus, and magnetic resonance imaging demonstrating bilateral subthalamic hyperdensities were consistent with Wernicke's encephalopathy. Nutritional stabilization and parenteral thiamine replacement resulted in rapid improvement of her ataxia and nystagmus and contributed to her recovery.


CONCLUSIONS
Wernicke's encephalopathy should be considered in patients with anorexia nervosa. Thiamine therapy could be considered in cases of anorexia nervosa with significant confusion.
Peters
Todd E
TE
Brown Medical School, Providence, Rhode Island, USA. Todd_Peters@brown.edu <Todd_Peters@brown.edu>
Parvin
Matthew
M
Petersen
Christopher
C
Faircloth
Vivian C
VC
Levine
Richard L
RL
D000293:Adolescent; D000856:Anorexia Nervosa / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D044342:Malnutrition / Q000150:complications; D013831:Thiamine / Q000627:therapeutic use; D013832:Thiamine Deficiency / Q000150:complications* / Q000175:diagnosis; D014899:Wernicke Encephalopathy / Q000175:diagnosis* / Q000209:etiology*
D013831:Thiamine