He Jingqi, Li Jinguang, Li Zhijun, Ren Honghong, Chen Xiaogang, Tang Jinsong
National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.
Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
Front Psychiatry. 2021 May 5;12:657649. doi: 10.3389/fpsyt.2021.657649. eCollection 2021.
Wernicke's encephalopathy (WE) is a severe neurological syndrome often associated with alcoholism. Clinicians tend to ignore WE in other non-alcoholic clinical settings related to malnutrition and thiamine deficiency, resulting in delayed diagnosis. The diagnosis becomes more difficult when WE is secondary to psychiatric illnesses as symptoms can be masked by the primary disease. We present a case of a 56-year-old female patient with schizophrenia who was admitted to the hospital for mental and behavioral disorder, without history of alcohol. She presented symptoms of ophthalmoplegia and high muscular tension, and the brain MRI showed symmetric lesions in the bilateral basal ganglia and third ventricle. She responded well to thiamine and was discharged on hospital day 22. The psychiatrists should be on the alert for starvation-induced WE, especially for patients suffering from malnutrition. WE is a preventable and treatable disease, so once suspected of WE, patients ought to take adequate supplements of thiamine immediately.
韦尼克脑病（WE）是一种常与酒精中毒相关的严重神经综合征。临床医生往往会忽视在与营养不良和硫胺素缺乏相关的其他非酒精性临床环境中的韦尼克脑病，从而导致诊断延迟。当韦尼克脑病继发于精神疾病时，诊断会变得更加困难，因为症状可能被原发性疾病掩盖。我们报告一例56岁女性精神分裂症患者，因精神和行为障碍入院，无饮酒史。她出现了眼肌麻痹和高肌张力症状，脑部MRI显示双侧基底节和第三脑室有对称病变。她对硫胺素反应良好，于住院第22天出院。精神科医生应警惕饥饿诱发的韦尼克脑病，尤其是对于营养不良的患者。韦尼克脑病是一种可预防和可治疗的疾病，所以一旦怀疑患有韦尼克脑病，患者应立即补充足够的硫胺素。
