Wernicke encephalopathy without delirium in patients with cancer
| Autor: | Yoshitada Taji, Mayumi Ishida, Iori Tanahashi, Takao Takahashi, Kenji Ikebuchi, Tatsuo Akechi, Daisuke Furuya, Hideki Onishi |
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| Rok vydání: | 2017 |
| Předmět: |
Pediatrics
medicine.medical_specialty Ataxia 03 medical and health sciences 0302 clinical medicine Neoplasms medicine Humans Outpatient clinic Wernicke Encephalopathy Thiamine General Nursing Palsy Gait Disturbance business.industry Delirium Thiamine Deficiency Cancer General Medicine Middle Aged medicine.disease Psychiatry and Mental health Clinical Psychology 030220 oncology & carcinogenesis Female medicine.symptom business human activities 030217 neurology & neurosurgery |
| Zdroj: | Palliative and Supportive Care. 16:118-121 |
| ISSN: | 1478-9523 1478-9515 |
| DOI: | 10.1017/s1478951517000360 |
| Popis: | Objective:Wernicke encephalopathy (WE) is a neuropsychiatric disorder caused by thiamine deficiency. Several reports of WE in cancer patients are known. WE is sometimes overlooked because most patients do not exhibit its typical symptoms (e.g., delirium, ataxia, ocular palsy). If delirium is not present, a diagnosis of WE is difficult because delirium is the hallmark symptom of WE.Method:Taken from a series on WE in cancer, we report two patients who developed WE without delirium during periodic psycho-oncology outpatient visits.Results:Case 1. A 61-year-old woman with non-Hodgkin lymphoma who was periodically attending a psycho-oncology outpatient clinic developed an unsteady gait. WE was suspected because she also developed appetite loss for two weeks, and we could find no other laboratory findings to explain her unsteady gait. Our diagnosis was supported by abnormal serum thiamine and disappearance of the gait disturbance after intravenous thiamine administration. Case 2. A 50-year-old woman with breast carcinoma with bone metastasis developed an unsteady gait. WE was suspected because she also developed loss of appetite for two weeks, and no other laboratory findings could explain her unsteady gait. The diagnosis was supported by abnormal serum thiamine and disappearance of the gait disturbance after administration of intravenous thiamine.Significance of Results:Our report emphasizes the importance of being aware of WE, even when patients do not present with delirium. The presence of loss of appetite for more than two weeks may be the key to a diagnosis of WE. |
| Databáze: | OpenAIRE |
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