Butt Ifrah, Ulloa Nicolas, Surapaneni Balarama K, Kasmin Franklin
Internal Medicine, Graduate Medical Education, Aventura Hospital, Aventura, USA.
Gastroenterology, Aventura Hospital, Aventura, USA.
Cureus. 2019 Jul 17;11(7):e5156. doi: 10.7759/cureus.5156.
Wernicke's Encephalopathy (WE) is a neurological condition characterized by ophthalmoplegia, ataxic gait, and altered mental status. It is an underdiagnosed yet severely limiting disease process precipitated by thiamine deficiency. Often times, it can occur in conjunction with other disease states like refeeding syndrome in which the underlying etiology is prolonged periods of malnutrition. We present a unique case of non-alcoholic WE in a middle-aged male who initially presented with gallstone pancreatitis complicated with severe metabolic derangements. This ultimately resulted in the development of non-alcoholic WE. Prevention of this condition is a clinical challenge for most physicians as the classic features associated with thiamine deficiency lack diagnostic sensitivity and specificity in critically ill patients. As a result, early recognition and prompt management of this can dramatically decrease morbidity and mortality. Our case highlights and emphasizes the importance of maintaining a high index of suspicion for WE and refeeding syndrome in the setting of altered sensorium and metabolic derangements.
韦尼克脑病（WE）是一种以眼肌麻痹、共济失调步态和精神状态改变为特征的神经系统疾病。它是一种因硫胺素缺乏引发的诊断不足但严重限制功能的疾病过程。通常情况下，它可能与其他疾病状态同时发生，如再喂养综合征，其潜在病因是长期营养不良。我们报告了一例中年男性非酒精性韦尼克脑病的独特病例，该患者最初表现为胆囊结石性胰腺炎并伴有严重的代谢紊乱，最终导致了非酒精性韦尼克脑病的发生。对大多数医生来说，预防这种疾病是一项临床挑战，因为与硫胺素缺乏相关的典型特征在重症患者中缺乏诊断敏感性和特异性。因此，对此病的早期识别和及时处理可显著降低发病率和死亡率。我们的病例突出并强调了在意识改变和代谢紊乱的情况下，对韦尼克脑病和再喂养综合征保持高度怀疑的重要性。
