Wernicke's encephalopathy in the course of chemoradiotherapy for head and neck cancer

Abstract

Wernicke's encephalopathy is a medical emergency. Immediate treatment with thiamine is required to prevent permanent neurologic injury. Although the classical context for Wernicke's encephalopathy is the malnourished alcoholic patient, it is seen in many other conditions in which thiamine deficiency arises. Indeed, 1 of the 3 initial cases reported by Wernicke et al [1] in 1881 developed as a consequence of esophageal injury after the ingestion of sulfuric acid. Wernicke's encephalopathy has been recognized with increasing frequency after bariatric surgery and with cancer [2-4]. Wernicke's encephalopathy occurring in the latter settings often results in diagnostic confusion resulting in a delay of therapy. We report 2 cases of Wernicke's encephalopathy occurring during the course of therapy for head and neck cancer.