Abstract
Wernicke encephalopathy is a rare neurological condition caused by tiamin deficiency and it has high morbidity and mortality rate. The disease is characterized by classical triad; confusion, ataxia and ophthalmoplegia. Although it is classically seen in alcoholic patients, some cases were reported due to malignity, hyperemesis and surgeries in patients who did not have any alcohol addiction. In this paper, we aimed to report a case who had no alcohol addiction despite he started to consume some in recent months, but who had history of Whipple surgery.
Keywords
Wernicke Encephalopathy Whipple General Surgery Alcoholism Thiamine Ataxia Ophthalmoplegia Confusion
References
- 1- Sechi G, Serra A. Wernicke's encephalopathy: new clinical settings and recent advances in diagnosis and management. Lancet Neurol 2007; 6(5): 442-455.2- Harper CG, Giles M, Finlay-Jones R. Clinical signs in the WernickeKorsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy. J Neurol Neurosurg Psychiatry 1986; 49: 341–345.3- Azim W, Walker R. Wernicke’s encephalopathy: a frequently missed problem. Hosp Med 2003; 64(6): 326-327.4- Başoğlu M, Yetimalar Y, Gürgör N, Büyükçatalbaş S, Kurt T, Seçil Y, et al. Neurological complications of prolonged hunger strike. Eur J Neurol 2006; 13(10): 1089-1097.5- Galvin R, Bråthen G, Ivashynka A, Hillbom M, Tanasescu R, Leone MA. EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. Eur J Neurol 2010; 17(12): 1408-1418.6- Davis RE, Icke GC. Clinical chemistry of thiamine. Adv Clin Chem 1983; 17: 93–140.7- Shaw S, Gorkin BD, Lieber CS. Effects of chronic alcohol feeding on thiamin status: biochemical and neurological correlates. Am J Clin Nutr 1981; 34(5): 856-860.8- Torvik, A. Wernicke’s encephalopathy–prevalence and clinical spectrum. Alcohol Alcohol 1991; 26 (Suppl. 1): 381–384.9- Martin P.R., Singleton C.K., and Hiller-Sturmhöfel S.: The role of thiamine deficiency in alcoholic brain disease. Alcohol Res Health 2003; 27(2): 134-14210- Reidling JC, Subramanian VS, Dudeja PK, Said HM. Expression and promoter analysis of SLC19A2 in the human intestine. Biochim Biophys Acta 2002; 1561(2): 180-187.11- Haid RW, Gutmann L, Crosby TW. Wernicke-Korsakoff encephalopathy after gastric plication. Jama 1982; 247(18): 2566-2567.12- Strasberg SM, Drebin JA, Soper NJ. Evolution and current status of the Whipple procedure: an update for gastroenterologists. Gastroenterology 1997;113(3): 983–99413- Grace DM, Alfieri MA, Leung FY. Alcohol and poor compliance as factors in Wernicke’s encephalopathy diagnosed 13 years after gastric bypass. Can J Surg 1998; 41(5): 389–39214- Antunez E, Estruch R, Cardenal C, Nicolas JM, Fernandez-Sola J, Urbano-Marquez A. Usefulness of CT and MR imaging in the diagnosis of acute Wernicke’s encephalopathy. AJR Am J Roentgenol 1998; 171(4): 1131–113715- Chung SP, Kim SW, Yoo IS, Lim YS, Lee G. Magnetic resonance imaging as a diagnostic adjunct to Wernicke encephalopathy in the ED. Am J Emerg Med 2003; 21: 497-502.16- Thomson AD, Cook CCH, Touquet R. The Royal College of Physicians report on alcohol: Guidelines for managing Wernicke’s encephalopathy in the accident and emergency department. Alcohol Alcoholism 2002; 37: 513-52117- Day E, Bentham P, Callaghan R. Thiamine for Wernicke-Korsakoff Syndrome in people at risk from alcohol abuse. Cochrane Database Syst Rev 2006; 1
Abstract
Wernicke ensefalopatisi, tiamin eksikliğine
bağlı, mortalitesi ve morbiditesi yüksek, nadir görülen nörolojik bir
hastalıktır. Hastalığın klinik triadı konfüzyon, ataksi ve oftalmoparezidir.
Klasik olarak alkol bağımlılarında görülmekle birlikte son yıllarda alkol
bağımlılığı olmayan kişilerde de malignite, hiperemesis ve geçirilmiş cerrahi
operasyonlara bağlı vakalar bildirilmiştir. Biz de, alkol bağımlılığı
olmamasına karşın, pankreas malignitesi nedeniyle 2 yıl önce Whipple cerrahisi
geçiren ve son zamanlarda alkol tüketmeye başlayan, Wernike Ensefalopatisi
gelişmesine bu iki faktörün bir arada sebep olduğunu düşündüğümüz bir olgu
sunmayı amaçladık.
References
- 1- Sechi G, Serra A. Wernicke's encephalopathy: new clinical settings and recent advances in diagnosis and management. Lancet Neurol 2007; 6(5): 442-455.2- Harper CG, Giles M, Finlay-Jones R. Clinical signs in the WernickeKorsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy. J Neurol Neurosurg Psychiatry 1986; 49: 341–345.3- Azim W, Walker R. Wernicke’s encephalopathy: a frequently missed problem. Hosp Med 2003; 64(6): 326-327.4- Başoğlu M, Yetimalar Y, Gürgör N, Büyükçatalbaş S, Kurt T, Seçil Y, et al. Neurological complications of prolonged hunger strike. Eur J Neurol 2006; 13(10): 1089-1097.5- Galvin R, Bråthen G, Ivashynka A, Hillbom M, Tanasescu R, Leone MA. EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. Eur J Neurol 2010; 17(12): 1408-1418.6- Davis RE, Icke GC. Clinical chemistry of thiamine. Adv Clin Chem 1983; 17: 93–140.7- Shaw S, Gorkin BD, Lieber CS. Effects of chronic alcohol feeding on thiamin status: biochemical and neurological correlates. Am J Clin Nutr 1981; 34(5): 856-860.8- Torvik, A. Wernicke’s encephalopathy–prevalence and clinical spectrum. Alcohol Alcohol 1991; 26 (Suppl. 1): 381–384.9- Martin P.R., Singleton C.K., and Hiller-Sturmhöfel S.: The role of thiamine deficiency in alcoholic brain disease. Alcohol Res Health 2003; 27(2): 134-14210- Reidling JC, Subramanian VS, Dudeja PK, Said HM. Expression and promoter analysis of SLC19A2 in the human intestine. Biochim Biophys Acta 2002; 1561(2): 180-187.11- Haid RW, Gutmann L, Crosby TW. Wernicke-Korsakoff encephalopathy after gastric plication. Jama 1982; 247(18): 2566-2567.12- Strasberg SM, Drebin JA, Soper NJ. Evolution and current status of the Whipple procedure: an update for gastroenterologists. Gastroenterology 1997;113(3): 983–99413- Grace DM, Alfieri MA, Leung FY. Alcohol and poor compliance as factors in Wernicke’s encephalopathy diagnosed 13 years after gastric bypass. Can J Surg 1998; 41(5): 389–39214- Antunez E, Estruch R, Cardenal C, Nicolas JM, Fernandez-Sola J, Urbano-Marquez A. Usefulness of CT and MR imaging in the diagnosis of acute Wernicke’s encephalopathy. AJR Am J Roentgenol 1998; 171(4): 1131–113715- Chung SP, Kim SW, Yoo IS, Lim YS, Lee G. Magnetic resonance imaging as a diagnostic adjunct to Wernicke encephalopathy in the ED. Am J Emerg Med 2003; 21: 497-502.16- Thomson AD, Cook CCH, Touquet R. The Royal College of Physicians report on alcohol: Guidelines for managing Wernicke’s encephalopathy in the accident and emergency department. Alcohol Alcoholism 2002; 37: 513-52117- Day E, Bentham P, Callaghan R. Thiamine for Wernicke-Korsakoff Syndrome in people at risk from alcohol abuse. Cochrane Database Syst Rev 2006; 1
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Case Report |
| Authors | |
| Publication Date | September 30, 2018 |
| Acceptance Date | August 30, 2018 |
| Published in Issue | Year 2018 Volume: 8 Issue: 3 |