title: Wernicke's encephalopathy after laparoscopic cardiomyotomy for achalasia.
abstract: Achalasia is an incurable neuromuscular disorder of the esophagus, resulting from destruction of the esophageal myenteric plexus. This leads to aperistalsis and failure of the lower esophageal sphincter to relax after swallowing. Symptoms of achalasia are gradual in onset and include dysphagia, regurgitation, and weight loss. Severe malnutrition can ensue. Wernicke's encephalopathy (WE) is a serious, potentially fatal, neurologic disorder caused by thiamine deficiency (vitamin B(1)), classically described as presenting with a triad of ocular abnormalities, ataxia, and confusion. The incidence is uncertain, and many cases likely go unrecognized. It is usually diagnosed in the alcoholic population. We describe its onset after the successful surgical treatment of achalasia.
authors.affiliation: Department of Upper Gastrointestinal Surgery, Royal Victoria Hospital, Belfast, Northern Ireland, United Kingdom. rpg.kennedy@btinternet.com
authors.forename: R
authors.initials: R
authors.lastname: Kennedy
authors.forename: S
authors.initials: S
authors.lastname: Hunt
authors.forename: J
authors.initials: J
authors.lastname: Ahmad
authors.forename: C
authors.initials: C
authors.lastname: Menezes
authors.forename: W B
authors.initials: WB
authors.lastname: Clements
authors.forename: J A
authors.initials: JA
authors.lastname: Kennedy
mesh_terms: D000328:Adult; D004931:Esophageal Achalasia / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013831:Thiamine / Q000627:therapeutic use*; D013832:Thiamine Deficiency / Q000150:complications*; D016896:Treatment Outcome; D014803:Vitamin B Complex / Q000627:therapeutic use*; D014899:Wernicke Encephalopathy / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D014803:Vitamin B Complex; D013831:Thiamine