Bilateral and symmetrical hyperintense lesions in pulvinar and dorsomedial thalami

Wernicke Encephalopathy Presenting in a Patient with Severe Acute Pancreatitis

Ana Cecilia Arana-Guajardo, Carlos Rodrigo Cámara-Lemarroy, Erick Joel Rendón- Ramírez, Joel Omar Jáquez-Quintana, Juan Fernando Góngora -Rivera, Dionicio Ángel Galarza-Delgado

Abstract


Context Acute pancreatitis can lead to prolonged fasting and malnutrition. Many metabolic changes, including thiamine deficiency, may lead to the well know pancreatic encephalopathy. In this condition however the thiamine deficiency is rarely suspected. Case report We report the case of a 17-year-old woman with severe acute pancreatitis who developed mental status changes and ophthalmoplegia. A magnetic resonance image showed hyperintensive signals in periventricular areas, medial thalamus, and mammillary bodies, findings consistent with the diagnosis of Wernicke encephalopathy. Thiamine treatment reversed neurological complications. Conclusion Wernicke encephalopathy secondary to thiamine deficiency should be considered as a possible cause of acute mental status changes in patients with acute pancreatitis and malnutrition. Prophylactic doses of thiamine could be considered in susceptible patients.


Keywords


Pancreatitis; Thiamine; Wernicke Encephalopathy

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DOI: http://dx.doi.org/10.6092/1590-8577/469

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