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Front Psychiatry 2021 5;12:657649. Epub 2021 May 5.

Department of Psychiatry, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Wernicke's encephalopathy (WE) is a severe neurological syndrome often associated with alcoholism. Clinicians tend to ignore WE in other non-alcoholic clinical settings related to malnutrition and thiamine deficiency, resulting in delayed diagnosis. The diagnosis becomes more difficult when WE is secondary to psychiatric illnesses as symptoms can be masked by the primary disease. Read More

Nutr Neurosci 2021 May 27:1-6. Epub 2021 May 27.

Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Objectives: Hyperemesis gravidarum is known to induce nutritional, water and electrolyte deficiencies which can be fatal if not treated urgently. Thiamine deficiency may lead to a constellation of neurological symptoms that include Wernicke encephalopathy. Moreover, Wernicke encephalopathy is typically manifested as ocular paresis, ataxia and confusion. Read More

J Family Med Prim Care 2021 Jan 30;10(1):567-571. Epub 2021 Jan 30.

Department of Neuromedicine, Bangur Institute of Neurosciences, Institute of Postgraduate Medical Education & Research and SSKM Hospital, Kolkata, West Bengal, India.

Wernicke's encephalopathy (WE) is an acute neurological condition characterized by the triad of ophthalmoparesis with nystagmus, ataxia, and global confusion. WE is a life-threatening illness caused by thiamine deficiency, primarily affecting the peripheral and central nervous systems. Thiamine deficiency is predominantly associated with chronic alcoholism, but various other causes have also been reported, including severe malnutrition, prolonged parenteral nutrition, malignancies, immunodeficiency syndromes, liver disease, hyperthyroidism and severe anorexia nervosa, and hyperemesis gravidarum. Read More

J Neurol Sci 2021 Jul 7;426:117482. Epub 2021 May 7.

Experimental Psychology, Helmholtz Institute, Utrecht University, the Netherlands; Slingedael Korsakoff Center, Lelie Care Group, Rotterdam, the Netherlands.

Background: Wernicke-Korsakoff syndrome (WKS) is a neurological disorder typically found in alcohol use disorder. The fact that it also occurs in nonalcoholic patients is less well known and often ignored. For the first time, this review offers a systematic investigation of the frequency and associated features of nonalcoholic WKS in the published literature. Read More

Neurology 2021 May 13. Epub 2021 May 13.

Department of Neurology, Texas Tech University Health Sciences Center, 3601 4 Street STOP 8321, Lubbock, Texas, United States

Obes Surg 2021 May 12. Epub 2021 May 12.

Department of General Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.

Cureus 2021 Mar 31;13(3):e14210. Epub 2021 Mar 31.

Psychiatry, Lewis Gale Medical Center, Salem, USA.

Wernicke encephalopathy has traditionally been associated with chronic alcohol abuse leading to thiamine deficiency. Clinical symptoms include mentation change, gait ataxia, and oculomotor abnormalities. However, it is often an underdiagnosed condition in patients suffering from chronic malnutrition, especially in the West. Read More

J Psychosom Res 2021 Jul 27;146:110503. Epub 2021 Apr 27.

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Objective: To determine if high dose intravenous (IV) thiamine can prevent delirium during hospitalization following allogeneic HSCT. Secondarily, we evaluated the effects of high dose IV thiamine on thiamine levels and explored risk factors for delirium.

Methods: Randomized, double-blind, placebo-controlled trial in patients undergoing allogeneic HSCT at a U. Read More

BMC Gastroenterol 2021 Apr 20;21(1):179. Epub 2021 Apr 20.

Department of Neurology, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.

Background: We present a case of a woman with a past medical history of irritable bowel syndrome (IBS) and anxiety, who presents with ophthalmoplegia, ataxia and memory loss, characteristic of Wernicke encephalopathy.

Case Presentation: A 64-year-old woman presented with double vision, unsteady gait and memory loss. These symptoms began after 3 months on an unfortified restricted diet, which she initiated to alleviate IBS symptoms. Read More

Cureus 2021 Mar 12;13(3):e13846. Epub 2021 Mar 12.

Internal Medicine, Medical Center of Trinity, Trinity, USA.

Korsakoff syndrome is a neuropsychiatric condition frequently seen as a progression of Wernicke's encephalopathy and is often associated with long-term alcohol abuse. It is characterized by further cognitive impairments, such as indiscriminate anterograde and retrograde amnesia, in addition to executive function deficits. As the syndrome is a result of severe thiamine deficiency, its management primarily focuses on nutritional replenishment and electrolyte maintenance. Read More

J Emerg Med 2021 Apr 6. Epub 2021 Apr 6.

Department of Emergency Medicine, University of California, San Diego, San Diego, California; Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego, San Diego, California.

Background: Thiamine deficiency is an uncommon cause of severe illness in the United States that can lead to significant morbidity because of high-output cardiac failure, peripheral neuropathy, and permanent neurologic impairment. We report the case of a middle-aged woman with extreme malnutrition caused by complications of Roux-en-Y gastric bypass (RYGB) surgery who presented with signs and symptoms of severe thiamine deficiency and septic shock.

Case Report: A 43-year-old woman who had undergone RYGB surgery and who had multiple complications presented to the emergency department with agitation, confusion, and lethargy. Read More

Brain Behav Immun Health 2021 Jul 31;14:100252. Epub 2021 Mar 31.

Laboratory of Psychoneuroimmunology, Psychosomatic Research Center, Oral Oncology Center, Araçatuba Dental School, São Paulo State University - UNESP, Araçatuba, São Paulo, Brazil.

Encephalopathy is one of the most frequent neurological complications of severe Coronavirus Disease 2019 (COVID-19) patients. Cytokine storm and sepsis, hypercatabolic states, the use of furosemide and dialytic therapy represent risk factors for thiamine deficiency and are also found in patients with severe COVID-19. In this retrospective case series, we report clinical and neurological findings of fifteen patients with COVID-19-associated Wernicke Encephalopathy (WE) and their response to treatment with intravenous thiamine. Read More

Neurohospitalist 2021 Apr 4;11(2):141-147. Epub 2020 Sep 4.

Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Philippines.

Background: Wernicke-Korsakoff syndrome (WKS) is a triad of ophthalmoplegia, ataxia and memory deficits due to thiamine insufficiency resulting from under- or untreated Wernicke's encephalopathy (WE), which may be associated with hyperemesis gravidarum (HEG).

Case Presentation: We present a case of a 36-year-old Filipino woman in her first trimester with HEG, along with the WKS triad and abnormal hyperintense signals in the bilateral thalami and midbrain, left occipital lobe, periaqueductal gray matter and pontine periventricular areas. Neurologic deficits partially improved but persisted despite intravenous thiamine administration. Read More

Am J Drug Alcohol Abuse 2021 Mar 29:1-7. Epub 2021 Mar 29.

Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY, USA.

Alcohol use disorder (AUD) is associated with thiamine deficiency and Wernicke-Korsakoff Syndrome (WKS). Thiamine supplementation for the prevention of WKS in patients with suspected AUD in the Emergency Department (ED) is generally recommended. As alcohol-related diagnoses are frequent reasons for visits to EDs, ED thiamine prescribing practices are relevant to the overall management and prevention of WKS in patients with AUD. Read More

Intern Med 2021 Mar 29. Epub 2021 Mar 29.

Division of General Medicine, Department of Comprehensive Medicine 1, Saitama Medical Center, Jichi Medical University, Japan.

BMJ Case Rep 2021 Mar 17;14(3). Epub 2021 Mar 17.

MetroHealth Medical Center, Hospital Medicnie, Case Western Reserve University, Cleveland, Ohio, USA

Thiamine is an essential cofactor in the process of nucleic acid synthesis. Neuronal tissues are especially sensitive to thiamine deficiency, manifesting as Wernicke's encephalopathy (WE). The typical triad of WE, encephalopathy, oculomotor dysfunction and gait ataxia, is only present in less than one-third of the cases. Read More

BMJ Case Rep 2021 Mar 16;14(3). Epub 2021 Mar 16.

Medicine, Kasturba Medical College Mangalore, Mangalore, India.

We report a case of a 26-year-old pregnant woman, who presented with subacute limb weakness. This was initially suspected to be Guillain-Barre syndrome but subsequently found to be the motor neuropathy of dry beriberi (vitamin B1, thiamine deficiency) along with associated Wernicke's encephalopathy (WE). The underlying cause was revealed as hyperemesis gravidarum (HG). Read More

Am J Case Rep 2021 Mar 15;22:e929891. Epub 2021 Mar 15.

Department of Critical Care, Jefferson Health New Jersey, Washington Township, NJ, USA.

BACKGROUND Wernicke encephalopathy (WE) is a neurological condition commonly associated with sustained alcohol abuse. However, it should be noted that disorders resulting in severe malnutrition, such as anorexia nervosa (AN), can precipitate nonalcoholic WE. AN is a life threatening psychological and eating disorder defined by inappropriate weight loss from food restriction due to the fear of gaining weight and immoderate desire to be thin. Read More

Front Neurol 2021 26;12:629273. Epub 2021 Feb 26.

Department of Medicine, University of the Region of Joinville (UNIVILLE), Joinville, Brazil.

Encephalopathy has been frequently reported in patients with acute respiratory distress syndrome (ARDS) related to COVID-19, and its etiology remains undetermined. These patients display hypercatabolic state, weight loss, use of diuretics, and dialytic therapy, which represent risk factors for thiamine depletion. The diagnosis of Wernicke encephalopathy (WE) is challenging and based on risk factors for the depletion of thiamine. Read More

Acta Biomed 2021 02 5;92(1):e2021055. Epub 2021 Feb 5.

Neurology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.

Non-alcoholic Wernicke Encephalopathy (WE) is an overlooked complication of malnourishment in all its forms including undernutrition, inadequate vitamine intake and endocrinological diseases. Both delay in treatment and overtreatment can lead to severe neurological life-long consequences. Inadequate management in patients with chronic malnutrition may cause abrupt osmolytes unbalance and subsequent osmotic demyelination syndromes. Read More

Rev Med Interne 2021 Feb 26. Epub 2021 Feb 26.

Service de Réanimation, Groupe Hospitalier Nord Essonne-Site Longjumeau, 159, rue du Président François Mitterrand, 91160 Longjumeau, France.

J Nerv Ment Dis 2021 03;209(3):229-231

Psychiatry and Mental Health Department, Centro Hopitalar Universitário Lisboa Norte.

Abstract: Wernicke encephalopathy (WE) results from thiamine deficiency. If undiagnosed or inadequately treated, WE evolves into Korsakoff syndrome (KS). We herein report a case of nonalcoholic Wernicke-Korsakoff syndrome (WKS) that resulted from malnutrition due to psychosis in a 42-years-old male patient. Read More

Nutrition 2021 06 30;86:111182. Epub 2021 Jan 30.

Experimental Psychology, Helmholtz Institute, Utrecht University, the Netherlands; Slingedael Korsakoff Center, Lelie Care Group, Rotterdam, the Netherlands.

Crohn's disease (CD) and ulcerative colitis (UC) are chronic and debilitating inflammatory conditions of the gastrointestinal tract. Thiamine can deplete rapidly in CD and UC, which can lead to Wernicke's encephalopathy (WE), is an acute neurologic disorder. Our objective was to systematically review the presentation of WE in CD and UC. Read More

BMJ Case Rep 2021 Feb 18;14(2). Epub 2021 Feb 18.

Department of Medicine, Okinawa Chubu Hospital, Uruma, Okinawa, Japan

Alcohol Clin Exp Res 2021 04 7;45(4):666-674. Epub 2021 Mar 7.

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.

Recent studies in alcohol use disorders (AUDs) have demonstrated some connections between carnitine metabolism and the pathophysiology of the disease. In this scoping review, we aimed to collate and examine existing research available on carnitine metabolism and AUDs and develop hypotheses surrounding the role carnitine may play in AUD. A scoping review method was used to search electronic databases in September 2019. Read More

Cureus 2021 Jan 6;13(1):e12537. Epub 2021 Jan 6.

Psychiatry, Cornerstone Healthcare System, Newburgh, USA.

Wernicke encephalopathy (WE) is an acute reaction to thiamine deficiency, which presents with the classic triad of ocular findings, cerebellar dysfunction, and confusion. However, thiamine deficiency can also present with several neuropsychiatric signs and symptoms other than the classical triad. We report a patient who presented with catatonia as a presenting feature of WE. Read More

J Community Hosp Intern Med Perspect 2021 Jan 26;11(1):147-151. Epub 2021 Jan 26.

Department of Medicine, University of Maryland Medical CenterMidtown Campus, Baltimore, Maryland, USA.

A 21-year-old male presented with a 2-week history of nausea and non-bloody, non-bilious vomiting, accompanied by diffuse chronic myalgia. The patient endorsed headaches, dizziness, and diplopia that had started one day prior to admission. The patient had consumed a meat-only diet for the prior year. Read More

BMJ Case Rep 2021 Feb 4;14(2). Epub 2021 Feb 4.

Pedeatric Oncology, Centro Hospitalar e Universitario de Coimbra EPE Hospital Pediátrico de Coimbra, Coimbra, Coimbra, Portugal.

Eur J Clin Nutr 2021 Jan 29. Epub 2021 Jan 29.

Department of Psycho-oncology, Saitama Medical University International Medical Center, Hidaka, Japan.

Background/objectives: Recent studies have revealed thiamine deficiency (TD) as a cause of delirium in cancer patients. However, the extent to which Wernicke encephalopathy is present and in what patients is not well understood.

Subjects/methods: In this retrospective descriptive study, we investigated referred cancer patients who were diagnosed with delirium by a psycho-oncologist to clarify the proportion of TD, the therapeutic effect of thiamine administration, and the factors involved in its onset. Read More