title: Bilateral Blindness Following Chemoradiation for Locally Advanced Oropharyngeal Carcinoma.
abstract: Wernicke's encephalopathy is a life-threatening neurologic complication of thiamine deficiency. Though the presentation of symptoms can vary widely, the classical triad is founded on ophthalmoplegia, alteration of mental status, and gait disturbance. We describe a case of Wernicke's encephalopathy in an oncology patient shortly after concurrent 5-fluorouracil, carboplatin, and radiotherapy for locally advanced oropharyngeal cancer, presenting as complete bilateral blindness, ataxia, nystagmus, and confusion. Thiamine was given based on clinical suspicion and rapid improvement of clinical findings occurred. An MRI performed later supported the diagnosis of Wernicke's encephalopathy. A multifactorial etiology of thiamine deficiency from nutritional deficits and neurotoxic effects of chemotherapy are hypothesized.
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: K Liang
authors.initials: KL
authors.lastname: Zeng
authors.affiliation: Medical Oncology, Schulich School of Medicine & Dentistry, London Regional Cancer Program, Western University, London, Ontario, CA.
authors.forename: Sara
authors.initials: S
authors.lastname: Kuruvilla
authors.affiliation: Medical Oncology, Schulich School of Medicine & Dentistry, London Regional Cancer Program, Western University, London, Ontario, CA.
authors.forename: Michael
authors.initials: M
authors.lastname: Sanatani
authors.affiliation: Department of Radiation Oncology, London Regional Cancer Program, Western University, London, Ontario, CA.
authors.forename: Alexander V
authors.initials: AV
authors.lastname: Louie
keywords: blindness; thiamine; wernicke's encephalopathy