Mauerman Kevin, Durojaye Samuel, Kutti Sridharan Gurusaravanan
Internal Medicine, University of Arizona College of Medicine, Tucson, USA.
Neurology, University of Arizona, Tucson, USA.
Cureus. 2020 May 22;12(5):e8242. doi: 10.7759/cureus.8242.
Most commonly seen with alcohol use disorder in the developed world, Wernicke's encephalopathy (WE), a disorder caused by thiamine deficiency can be readily missed in the setting of other predisposing conditions such as malnutrition, the most common cause worldwide. We present a case of a 21-year-old female with sudden progressive decline in her level of alertness and mentation along with severe hypothermia who had clinical features and imaging findings consistent with WE in the setting of pancreatitis and chronic gastritis. WE should be suspected in all patients who present with altered mental status (AMS) and who are at an increased risk of malnutrition despite a normal or high body mass index, so that treatment with thiamine may be initiated and further neurologic sequelae can be averted.
在发达国家，韦尼克脑病（WE）最常与酒精使用障碍相关，它是一种由硫胺素缺乏引起的疾病，在其他易患因素如营养不良（全球最常见的原因）的情况下很容易被漏诊。我们报告一例21岁女性病例，该患者出现警觉性和精神状态突然进行性下降，伴有严重体温过低，其临床特征和影像学表现与胰腺炎和慢性胃炎背景下的韦尼克脑病相符。对于所有出现精神状态改变（AMS）且尽管体重指数正常或偏高但存在营养不良风险增加的患者，均应怀疑韦尼克脑病，以便开始使用硫胺素治疗并避免进一步的神经后遗症。
