WERNICKE ENCEPHALOPATHY - CAUSES TO CONSIDER

Wernicke's encephalopathy (WE) is a thiamine deficiency disorder and i s characterized clinically by the triad of ocular abnormalities, ataxi a and disturbances of consciousness. We report on 3 patients with WE, of whom 2 had insufficient thiamine substitution. In the first patient symptoms disappeared during thiamine substitution. In the second pati ent acute WE was the terminating event in the sequence of parenteral n utrition, lactic acidosis and cardio-pulmonary decompensation. Possibl y due to heriditary deficits WE developed in the third patient despite sufficient thiamine substitution. Attention to thiamine deficiency sh ould be paid in all patients with history of alcoholism, malnutrition, malabsorption, tumors, inflammation, other severe diseases and in par enteral hyperalimentation. In order to prevent WE thiamine should be s ubstituted with at least 100 mg/day i.v. or i.m.