title: Alcohol dementia and thermal dysregulation: a case report and review of the literature.
abstract: Wernicke's encephalopathy and Korsakoff's psychosis in alcoholics are thought to be due to thiamine deficiency. When the process goes untreated, patients may develop alcohol-induced persisting dementia. We review the literature on thermal dysregulation and the place of thiamine treatment in Wernicke's encephalopathy, Korsakoff's psychosis, and alcohol-induced persisting dementia. We describe a patient with alcohol-induced persisting dementia who showed thermal dysregulation which responded to parenteral but not oral thiamine. Subsequently, he developed aspiration pneumonia with associated fever reaction and expired. We describe the neuroimaging findings--diffuse cortical atrophy, ventricular dilatation, atrophy of the corpus callosum, hypothalamus, and medulla, and a probable arachnoid cyst in the left temporal tip. We conclude that thermal dysregulation was likely related to dysfunction of temperature regulatory brain centers, that thermal dysregulation was stabilized with parenteral but not oral thiamine, and that parenteral thiamine may have a role even in chronic cases of alcohol-induced persisting dementia.
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut, USA. ktanev@uchc.edu
authors.forename: Kaloyan S
authors.initials: KS
authors.lastname: Tanev
authors.forename: Melissa
authors.initials: M
authors.lastname: Roether
authors.forename: Clifford
authors.initials: C
authors.lastname: Yang
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000150:complications*; D001284:Atrophy; D001833:Body Temperature Regulation / Q000187:drug effects; D002540:Cerebral Cortex / Q000473:pathology; D003704:Dementia / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D017809:Fatal Outcome; D005334:Fever / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007031:Hypothalamus / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D013831:Thiamine / Q000008:administration & dosage / Q000627:therapeutic use*; D013832:Thiamine Deficiency / Q000188:drug therapy* / Q000209:etiology; D014803:Vitamin B Complex / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D014803:Vitamin B Complex; D013831:Thiamine