Korean J Crit Care Med.  2010 Sep;25(3):186-189. 10.4266/kjccm.2010.25.3.186.

A Case of Wernicke's Encephalopathy in a Postoperative Patient with Parenteral Nutrition and Temporary Oral Feeding: A Case Report

• Lee H
• Lee EH
• Lee SC
• Park HP

• KMID: 2228206
• DOI: http://doi.org/10.4266/kjccm.2010.25.3.186

Abstract

Wernicke's encephalopathy is an acute neurological disorder, caused by thiamine deficiency, which is clinically characterized by a triad of ophthalmoplegia, ataxia and disturbances of consciousness. Most frequently, the encephalopathy is a consequence of chronic alcoholism, but it may occur in other forms of malnutrition or malabsorption, such as in prolonged parenteral nutrition without the addition of thiamine, total gastrectomy, gastrojejunostomy, severe anorexia or hyperemesis gravidarum. Thiamine requirement increases during critical illness and in chronically depleted patients, and its supplementation may influence the outcome of the disease. We report a case of a 73-year-old man, who presented with recurred colon cancer, who was affected by Wernicke's encephalopathy while undergoing oral feeding and parenteral nutrition. This case suggests that we should be more aware of potential thiamine deficiency in critically ill patients, even those undergoing parenteral nutrition and temporary oral feeding.

Keyword

oral feeding; parenteral nutrition; thiamine deficiency; Wernicke's encephalopathy

MeSH Terms

Aged
Alcoholism
Anorexia
Ataxia
Colonic Neoplasms
Consciousness
Critical Illness
Female
Gastrectomy
Gastric Bypass
Humans
Hyperemesis Gravidarum
Malnutrition
Nervous System Diseases
Ophthalmoplegia
Parenteral Nutrition
Pregnancy
Thiamine
Thiamine Deficiency
Wernicke Encephalopathy
Thiamine