Thiamine-responsive acute neurological disorders in nonalcoholic patients

Wernicke's encephalopathy (WE) is most commonly associated with alcoholism, although other causes have also been implicated. In the years 1994-1997, 9 patients with no history of alcohol abuse presented with acute signs of op hthalmoplegia or nystagmus and ataxia which resolved within 48 h after intr avenous thiamine, There were 7 women and 2 men aged 17-57 (7 below the age of 30). Precipitating events included vomiting 2, drastic weight-reducing d iet 2, renal colic in a postpartum woman 1, colonic surgery 2 and chronic h emodialysis 1. In 2 patients there was no obvious precipitating event but t heir history was suggestive of a genetic predisposition. Mental changes wer e slight or absent in all patients and all of them made good functional rec overy. These cases suggest that the diagnosis of WE should be considered mo re often in nonalcoholics in various clinical settings. Copyright (C) 2001 S. Karger AG, Basel.