Wernicke Encephalopathy and Other Vitamin Deficiencies in a Patient with Home Parenteral Nutrition
Wernicke Encephalopathy (WE) is an acute and serious secondary neurological syndrome caused by a deficit of thiamine or vitamin B1. Although it rarely presents with the classic triad,
the most frequent presenting symptoms are: mental confusion, ocular-motor dysfunction and ataxia.
Laboratory and image studies can be useful, but diagnosis is fundamentally clinical, and if this syndrome is suspected treatment must be started as soon as possible. The most
frequent cause in our setting is chronic alcoholism; however, there are increasing numbers of
reported cases secondary to parenteral nutrition not correctly supplemented with vitamins.
Here we present a case of WE secondary to parenteral nutrition not correctly supplemented with vitamins.
This patient presented the classic clinical triad and was therefore diagnosed and treated
rapidly, responding to treatment in an effective manner.
Thus, the clinical presentation corresponded to a deficit of other vitamins associated
with the same vitamin complex iv that was not administered, including
a regenerative anemia and eczema craquele.
This case emphasizes the need to supplement parenteral nutrition with thiamine and other vitamins.
At the same time, it stresses the importance of suspecting this syndrome in all clinically
compatible patients with non-vitamin supplemented parenteral nutrition.
Neuro Open J. 2014; 1(1): 16-19. doi: 10.17140/NOJ-1-104
