Wernicke's encephalopathy in a patient with acute alcoholic pancreatitis / 대한내과학회지

ABSTRACT

Wernicke's encephalopathy is a serious neurological disorder caused by thiamine deficiency that is characterized by the triad of ocular abnormalities, ataxia, and global confusional state. It is most often seen in alcoholics, but it can be seen in disorders associated with malnutrition and with prolonged intravenous feeding without appropriate vitamin supplementation. We report the case of a 51-year-old man with acute alcoholic pancreatitis and chronic alcoholism with an intraperitoneal abscess, who presented with Wernicke's encephalopathy. He was initially treated by fasting, intravenous fluid replacement, and intermittent vitamin infusion for 3 weeks. After subsequently starting a high carbohydrate oral diet, the patient developed diplopia, orientation disturbance, ataxia, a confusional state, and nystagmus. His neurologic signs and symptoms normalized gradually after intravenous thiamine supplementation.