Treatment of Wernicke's encephalopathy with high dose of thiamine in a patient with pyloric sub-stenosis: description of a case.
Wernicke's encephalopathy (WE) is an acute or subacute syndrome that results from a deficiency in vitamin B1 (thiamine). The syndrome is characterised by a classical triad of symptoms: nystagmus and ophthalmoplegia,mental-status changes, and unsteadiness of stance and gait. When patients with WE are inappropriately treated with low doses of thiamine, mortality rates average out at 20% and Korsakoff's Psychosis develops in about 85% of survivors(Sechi and Serra in Lancet Neurol 6(5):442–455,2007). We report the case of a patient with a pyloric substenosis that developed a WE, and was treated with high doses of thiamine showing after few days of treatment a great improvement of neurological and neuroradiological assessment, even though cognitive impairment was still severe at discharge and at 6 months follow-up.
Caso
Francesca
F
Department of Neurology, San Raffaele Scientific Institute, Via Olgettina 48, Milan, Italy. caso.francesca@hsr.it
Fiorino
A
A
Falautano
M
M
Leocani
L
L
Martinelli
V
V
Minicucci
F
F
Falini
A
A
Comi
G
G
Magnani
G
G
D004305:Dose-Response Relationship, Drug; D006801:Humans; D008297:Male; D008875:Middle Aged; D011707:Pyloric Stenosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013831:Thiamine / Q000008:administration & dosage*; D014803:Vitamin B Complex / Q000008:administration & dosage*; D014899:Wernicke Encephalopathy / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*
D014803:Vitamin B Complex; D013831:Thiamine
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