Nonalcoholic Wernicke’s Encephalopathy Associated with Unintentional Weight Loss, Cholecystectomy, and Intractable Vomiting : The Role of Dual Thiamine and Corticosteroid Therapy
Joint Authors
Zaretskaya, Marina
Gomez, Leslie
Verma, Vivek
Donadee, Chenell
Source
Case Reports in Neurological Medicine
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-01-19
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
A 23-year-old male with one month of intractable vomiting, subsequent cholecystitis status post cholecystectomy, and overall 40-pound weight loss over the last few months presented with altered mental status and seizures.
MRI showed signal abnormalities involving the hypothalamus, periaqueductal gray matter, 4th ventricle, and bilateral thalami, indicative of Wernicke’s encephalopathy.
The patient was started on empiric IV thiamine and methylprednisolone; thiamine levels were subsequently found to be low.
Infectious disease workup was negative.
Within a few days of this therapy, the patient’s neurological status steadily improved with increased responsiveness and communication.
Repeat MRI 7 days after admission showed significant resolution of the signal abnormalities.
Over the next several weeks the patient became fully conversational, cognitively intact, and increasingly ambulatory.
Nonalcoholic Wernicke’s encephalopathy is rare; there have been reports relating it separately to vomiting and invasive surgery.
In this case report, we associate it with both recurrent vomiting and minimally invasive cholecystectomy.
We also discuss combinatorial therapy of thiamine and corticosteroids, which is poorly defined in the literature.
Though there is no consensus-based optimal treatment of Wernicke’s encephalopathy, this adds to the discussion of using dual therapy and supports that the use of empiric corticosteroids does not harm the patient.
American Psychological Association (APA)
Verma, Vivek& Donadee, Chenell& Gomez, Leslie& Zaretskaya, Marina. 2014. Nonalcoholic Wernicke’s Encephalopathy Associated with Unintentional Weight Loss, Cholecystectomy, and Intractable Vomiting : The Role of Dual Thiamine and Corticosteroid Therapy. Case Reports in Neurological Medicine،Vol. 2014, no. 2014, pp.1-5.
https://search.emarefa.net/detail/BIM-471696
Modern Language Association (MLA)
Verma, Vivek…[et al.]. Nonalcoholic Wernicke’s Encephalopathy Associated with Unintentional Weight Loss, Cholecystectomy, and Intractable Vomiting : The Role of Dual Thiamine and Corticosteroid Therapy. Case Reports in Neurological Medicine No. 2014 (2014), pp.1-5.
https://search.emarefa.net/detail/BIM-471696
American Medical Association (AMA)
Verma, Vivek& Donadee, Chenell& Gomez, Leslie& Zaretskaya, Marina. Nonalcoholic Wernicke’s Encephalopathy Associated with Unintentional Weight Loss, Cholecystectomy, and Intractable Vomiting : The Role of Dual Thiamine and Corticosteroid Therapy. Case Reports in Neurological Medicine. 2014. Vol. 2014, no. 2014, pp.1-5.
https://search.emarefa.net/detail/BIM-471696
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-471696