Wernicke Encephalopathy: A Complication of Parenteral Nutrition Diagnosed by Magnetic Resonance Imaging

Attard, Olivier; Dietemann, J L; Diemunsch, Pierre; Pottecher, T; Meyer, Alain; Calon, B.

doi:10.1097/00000542-200610000-00032

Cited by 28 publications

(7 citation statements)

References 13 publications

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“…13 In addition, hyperemesis gravidarum, [14][15][16] chemical therapy, 17 anorexia nervosa, 18 AIDS, 19 and even wrong formula feeding 20 were also reported as predisposing factors (Table 1). 6,[21][22][23][24][25][26][27] Because the healthy body's reserves of thiamine are sufficient for up to 18 days, any condition that induces thiamine deficiency lasting 2 to 3 weeks may lead to WE. Prophylactic use of thiamine with nutritional guidance should be recommended to avoid the development of WE in patients with possible thiamine deficiency.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and MR Imaging Features of Nonalcoholic Wernicke Encephalopathy

Fei¹,

Zhong²,

Jin³

et al. 2008

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and MR Imaging Features of Nonalcoholic Wernicke Encephalopathy

Fei¹,

Zhong²,

Jin³

et al. 2008

AJNR Am J Neuroradiol

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“…Wernicke's encephalopathy can be caused by thiamine deficiency associated with chronic alcohol abuse, malnutrition or unbalanced nutrition, gastrointestinal surgery, recurrent vomiting, chronic diarrhea, systemic illness, or magnesium depletion, all of which can affect thiamine uptake and utilization (7-9). Wernicke's encephalopathy can be diagnosed primarily from the clinical features, and it should be confirmed by symptomatic improvement with thiamine treatment (10).…”

Section: Discussionmentioning

confidence: 99%

A Case of Wernicke's Encephalopathy Following Fluorouracil-based Chemotherapy

et al. 2009

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The pyrimidine antimetabolite 5-fluorouracil (5-FU) is a chemotherapeutic agent used widely for various tumors. Common side effects of 5-FU are related to its effects on the bone marrow and gastrointestinal epithelium. Neurotoxicity caused by 5-FU is uncommon, although acute and delayed forms have been reported. Wernicke's encephalopathy is an acute, neuropsychiatric syndrome resulting from thiamine deficiency, and has significant morbidity and mortality. Central nervous system neurotoxicity such as Wernicke's encephalopathy following chemotherapy with 5-FU has been reported rarely, although it has been suggested that 5-FU can produce adverse neurological effects by causing thiamine deficiency. We report a patient with Wernicke's encephalopathy, reversible with thiamine therapy, associated with 5-FU-based chemotherapy.

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“…This complication should have been avoided given that clinical experience of TPN in surgical patients dates back more than 40 years. In the literature, very few cases of Wernicke's encephalopathy were reported after oncologic gastrointestinal surgery during TPN, the localization of gastrointestinal cancer was the stomach and the pancreas (Table 1) [32][33][34][35][36][37][38][39][40][41][42][43][44].…”

Section: Discussionmentioning

confidence: 99%

Total parenteral nutrition-induced Wernicke’s encephalopathy after oncologic gastrointestinal surgery

et al. 2020

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Carl Wernicke described the disease bearing his name in 1881 and reported three cases characterized by the presence of mental confusion, ataxia, and ophthalmoplegia. Wernicke’s disease is mainly observed in alcoholic patients, due to decreased vitamin intake as a consequence of an unbalanced diet, and a reduction of absorption due to the effects of alcohol. Likewise, inadequate vitamin intake is prevalent in older patients. Wernicke’s encephalopathy due to inappropriate total parenteral nutrition (TPN) occurs infrequently; recently, there is an increase in the literature concerning Wernicke’s encephalopathy in patients after general and bariatric surgeries. We present two cases of Wernicke’s encephalopathy after oncologic gastrointestinal surgery by failure to administer vitamin B1 during TPN; to our knowledge, these are the first two cases of Wernicke’s encephalopathy after colorectal surgery for cancer. In our opinion, timely diagnosis and treatment are mandatory to avoid nonfunctional recovery and consequent malpractice legal actions as well as an increase in the health-care costs correlated with the prolonged hospital stay and with the nonfunctional recovery.

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Wernicke Encephalopathy: A Complication of Parenteral Nutrition Diagnosed by Magnetic Resonance Imaging

Cited by 28 publications

References 13 publications

Clinical Characteristics and MR Imaging Features of Nonalcoholic Wernicke Encephalopathy

Clinical Characteristics and MR Imaging Features of Nonalcoholic Wernicke Encephalopathy

A Case of Wernicke's Encephalopathy Following Fluorouracil-based Chemotherapy

Total parenteral nutrition-induced Wernicke’s encephalopathy after oncologic gastrointestinal surgery

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