A Case of Wernicke's Encephalopathy after Long-Term Intravenous Feeding.

Kim, Joon Hyun; Kim, Dong Seob; Shin, Jung Chul

Case Report

Journal of the Korean Ophthalmological Society 1996;37(11):1958-1962.
Published online November 1, 1996.

A Case of Wernicke's Encephalopathy after Long-Term Intravenous Feeding.

Joon Hyun Kim, Dong Seob Kim, Jung Chul Shin

Department of Ophthalmology, College of Medicine, Hanyang University Seoul Hospital, Korea.

장기간 수액요법후 발생한 Wernicke`s Encephalopathy 1례

김준현(Joon Hyun Kim),김동섭(Dong Seob Kim),신정철(Jung Chul Shin)

Abstract

Wernicke's encephalopathy is characterized by one or more following symptoms: nystagmus, ophthalmoplegia, such as lateral rectus muscle palsy and conjugate palsy, ataxia of gate and mental confusion. The main cause of Wernicke's encephalopathy is malnutrition associated with chronic alcholism, but it occurs in such conditions as pyloric stenosis, hyperemesis gravidarum, gastrointestinal malignancy, chronic starvation therapy for obesity, and so on. We experienced a 38-year-old patient with Wernicke's encephalopathy, who had about 1 month intravenous feeding, preceded by intractable vomiting. The patient showed complete bilateral horizontal conjugate gaze palsy and abduction palsy, but spa ired vertical gaze and convergence without nystagmus. Ophthalmoplegia was improved after parenteral thiamine administration, but horizontal gaze evoked nystagmus occurred and persisted after 6months. We report a case of Wernicke's encephalopathy which occurred after long term intravenous feeding unassociated with chronic alcoholism.

Key Words: Ophthalmoplegia;Thiamine;Wernicke's encephalopathy