Wernicke's encephalopathy in a child with high dose thiamine therapy

So Won Park, Yoon Young Yi, Jung Woo Han, Heung Dong Kim, Joon Soo Lee, Hoon Chul Kang

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Wernicke’s encephalopathy is an acute neurological disorder characterized by mental confusion, oculomotor dysfunction, and ataxia. It has been reported in individuals with alcohol dependence, hyperemesis gravidarum, and prolonged parenteral nutrition without vitamin supplementation. Here we present the case of a 13-year-old male patient with neuroblastoma and a history of poor oral intake and nausea for 3 months. After admission, he showed gait disturbances, nystagmus, and excessive dizziness; his mental state, however, indicated he was alert, which did not fit the classical triad of Wernicke’s encephalopathy. A diagnosis of Wernicke’s encephalopathy was made only after brain magnetic resonance imaging and serum thiamine level analyses were performed. The patient’s symptoms remained after 5 days of treatment with 100-mg thiamine once daily; thus, we increased the dosage to 500 mg 3 times daily, 1,500 mg per day. His symptoms then improved after 20 days of replacement therapy. This case report describes a pediatric patient who was promptly diagnosed with Wernicke’s encephalopathy, despite only 2 suspicious symptoms, and who completely recovered after high doses of thiamine were given intravenously.

Original languageEnglish
Pages (from-to)496-499
Number of pages4
JournalKorean Journal of Pediatrics
Volume57
Issue number11
DOIs
Publication statusPublished - 2014 Nov 1

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Pediatrics

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