title: Wernicke encephalopathy in pediatric neuro-oncology: presentation of 2 cases and review of literature.
abstract: Wernicke encephalopathy represents a well-known entity characterized by a set of cognitive and neurologic alterations. Wernicke encephalopathy is rare and under-recognized in childhood and may be fatal. Few cases have been documented in pediatric oncology. We report on 2 Wernicke encephalopathy cases that occurred in children having a brain tumor. The diagnosis of Wernicke encephalopathy was suggested by clinical manifestations associated with the typical radiologic findings and a laboratory evidence of thiamine deficiency. No large series have been published to support the evidence that pediatric malignancies represent a demonstrated factor of increased risk to develop a Wernicke encephalopathy. Moreover, the diagnosis may be even more difficult in brain tumors, considering the overlapping symptoms and the risk of encephalopathy related to both the disease and the treatment. Wernicke encephalopathy should be considered in all children with cancer presenting a neurologic deterioration, mainly in brain tumors. An early diagnosis is imperative for a prompt therapy that might prevent or minimize the irreversible brain damage related to this condition.
authors.affiliation: Ospedale Pediatrico Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
authors.forename: Maria Giuseppina
authors.initials: MG
authors.lastname: Cefalo
authors.affiliation: Ospedale Pediatrico Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: De Ioris
authors.affiliation: Ospedale Pediatrico Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Cacchione
authors.affiliation: Ospedale Pediatrico Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Longo
authors.affiliation: Ospedale Pediatrico Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Staccioli
authors.affiliation: University of Perugia, S.M. Misericordia University Hospital, Perugia, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Arcioni
authors.affiliation: Ospedale Pediatrico Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Bernardi
authors.affiliation: Ospedale Pediatrico Bambino Gesù Children's Hospital IRCCS, Rome, Italy angela.mastronuzzi@opbg.net.
authors.forename: Angela
authors.initials: A
authors.lastname: Mastronuzzi
mesh_terms: D001921:Brain / Q000473:pathology*; D001932:Brain Neoplasms / Q000150:complications*; D002648:Child; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008495:Medical Oncology; D009462:Neurology; D014899:Wernicke Encephalopathy / Q000175:diagnosis* / Q000209:etiology*
keywords: Wernicke encephalopathy; brain cancer; childhood