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一例回肠旁路手术后发生的韦尼克脑病病例。

A Case of Wernicke Encephalopathy Developing After Ileal Bypass Surgery.

作者信息

Kamaşak Tülay, Kul Sibel, Tuşat Mustafa, Ozgun Nezir, Cansu Ali

机构信息

From the Departments of Pediatric Neurology.

Radiology, and.

出版信息

Pediatr Emerg Care. 2018 Dec;34(12):e223-e225. doi: 10.1097/PEC.0000000000001472.

Abstract

Wernicke encephalopathy is an acute neurological problem resulting from thiamine deficiency and manifesting with mental confusion, oculomotor dysfunction, and ataxia. It is associated with alcohol dependence in adults. Preparatory factors include hyperemesis gravidarum, prolonged diarrhea, prolonged parental nutrition without vitamin support, absorption disorders, anorexia, cancer, and chemotherapy. Failure to consider the clinical findings and preparatory factors of this disease, which is rare in children, can delay diagnosis. This report describes a case of Wernicke encephalopathy developing in a patient with brid ileus and receiving total parenteral nutrition after partial ileal bypass surgery. The patient's clinical and cranial magnetic resonance findings were compatible with Wernicke encephalopathy. Although these are not widespread, typical ocular findings for Wernicke encephalopathy were present. Dramatic improvements were observed in clinical, ocular, and cranial magnetic resonance findings after treatment.

摘要

韦尼克脑病是一种由硫胺素缺乏引起的急性神经问题,表现为精神错乱、动眼功能障碍和共济失调。在成人中,它与酒精依赖有关。诱发因素包括妊娠剧吐、长期腹泻、无维生素支持的长期肠外营养、吸收障碍、厌食、癌症和化疗。由于这种疾病在儿童中罕见,如果不考虑其临床表现和诱发因素,可能会延迟诊断。本报告描述了一例在部分回肠旁路手术后患有肠梗阻并接受全肠外营养的患者发生韦尼克脑病的病例。患者的临床和头颅磁共振成像结果与韦尼克脑病相符。虽然这些表现并不普遍,但韦尼克脑病的典型眼部表现存在。治疗后,临床、眼部和头颅磁共振成像结果均有显著改善。

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