Total parenteral nutrition caused Wernicke’s encephalopathy accompanied by wet beriberi

Abstract

Patient: Female, 17Final Diagnosis: Wernicke’s encephalopathySymptoms: Blurred vision • dizziness • nystygmus • tachycardiaMedication: —Clinical Procedure: —Specialty: NeurologyObjective:Mistake in diagnosisBackground:Wernicke’s encephalopathy (WE) is an acute and life-threatening illness which is not only seen in alcoholics, but also in persons with poor nutrition lacking thiamine (vitamin B1).Case Report:Here, we presented a case of WE in a patient who received parenteral nutrition without complement of thiamine. Besides neuropsychiatric problems, she also manifested prominent cardiovascular abnormalities, which were consistent with wet beriberi.Conclusions:This case emphasizes the need for thiamine supplementation in prolonged total parenteral nutrition, and also highlights the awareness of WE in persons with parenteral nutrition lacking thiamine. More importantly, we call for attention to wet beriberi in such persons.