Seo Yui, Reed Mark, Chang Jason S, Lui Forshing
Medicine, California Northstate University College of Medicine, Elk Grove, USA.
Internal Medicine, California Northstate University College of Medicine, Elk Grove, USA.
Cureus. 2022 Dec 8;14(12):e32320. doi: 10.7759/cureus.32320. eCollection 2022 Dec.
Wernicke's encephalopathy (WE) is a neuropsychiatric condition caused by thiamine deficiency often associated with alcoholism. Other less common causes include prolonged gastroenterology problems or dietary insufficiencies associated with hyperemesis gravidarum, bariatric surgery, and eating disorders. Prolonged WE without proper treatment can lead to the chronic and irreversible condition, Wernicke-Korsakoff syndrome. Despite being known for its classic triad of clinical symptoms (nystagmus/ophthalmoplegia, gait ataxia, and confusion), WE patients more commonly present with non-specific symptoms of altered mental status. Obscure clinical presentations often led to delays in the appropriate of patients with WE. We are presenting a case of WE that is unusual because the underlying cause is schizophrenia and the lack of alcohol use. For a punctual diagnosis, a high index of suspicion is essential to prevent further exacerbation of neuronal death seen in WE. IV thiamine should be administered to any patient with acute encephalopathy or altered mental status, given its low cost and lack of side effects.
韦尼克脑病（WE）是一种由硫胺素缺乏引起的神经精神疾病，常与酒精中毒有关。其他不太常见的病因包括长期的胃肠疾病或与妊娠剧吐、减肥手术和饮食失调相关的饮食不足。未经适当治疗的长期韦尼克脑病可导致慢性且不可逆的韦尼克-科萨科夫综合征。尽管韦尼克脑病以其经典的三联征临床症状（眼球震颤/眼肌麻痹、步态共济失调和意识模糊）而闻名，但韦尼克脑病患者更常表现为精神状态改变的非特异性症状。隐匿的临床表现常常导致韦尼克脑病患者的诊断延迟。我们报告一例不寻常的韦尼克脑病病例，其潜在病因是精神分裂症且无饮酒史。为了及时诊断，高度的怀疑指数对于防止韦尼克脑病中所见神经元死亡的进一步加重至关重要。鉴于静脉注射硫胺素成本低且无副作用，应给予任何患有急性脑病或精神状态改变的患者静脉注射硫胺素。
