Cefalo Maria Giuseppina, De Ioris Maria Antonietta, Cacchione Antonella, Longo Daniela, Staccioli Susanna, Arcioni Francesco, Bernardi Bruno, Mastronuzzi Angela
Ospedale Pediatrico Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
University of Perugia, S.M. Misericordia University Hospital, Perugia, Rome, Italy.
J Child Neurol. 2014 Dec;29(12):NP181-5. doi: 10.1177/0883073813510355. Epub 2013 Nov 28.
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.
韦尼克脑病是一种以一系列认知和神经改变为特征的知名病症。韦尼克脑病在儿童期罕见且未得到充分认识，可能会致命。儿科肿瘤学中记录的病例很少。我们报告了2例发生在患有脑肿瘤儿童中的韦尼克脑病病例。韦尼克脑病的诊断是根据与典型影像学表现相关的临床表现以及硫胺素缺乏的实验室证据提出的。目前尚未发表大量系列研究来支持儿科恶性肿瘤是发生韦尼克脑病风险增加的已证实因素这一证据。此外，考虑到脑肿瘤存在重叠症状以及与疾病和治疗相关的脑病风险，诊断可能更加困难。对于所有出现神经功能恶化的癌症儿童，尤其是脑肿瘤患儿，都应考虑韦尼克脑病。早期诊断对于可能预防或最小化与该病症相关的不可逆脑损伤的及时治疗至关重要。
