Abstract:
Wernicke\'s encephalopathy (WE) is a dangerous and potentially fatal neurological condition associated with thiamin deficiency. The standard treatment for WE is intravenous (IV) thiamin, but limited research describes optimal dosing. We present a case of a 40-year-old male with severe alcohol use disorder (AUD) and chronic malnourishment who developed WE. Upon administration of 100 mg IV thiamin, symptoms of WE persisted, but when the dose was increased to 500 mg, altered mental status and ophthalmoplegia resolved rapidly. IV thiamin is a reliable and low-risk treatment for WE, even when administered at high doses. High-dose IV thiamin (i.e., >/100 mg) can treat neurological symptoms and cognitive dysfunction in WE and should be considered for first-line treatment. Further study of WE diagnostic and treatment guidelines is warranted to maximize recovery potential.
摘要:
Wernicke脑病(WE)是一种危险且可能致命的神经系统疾病,与硫胺素缺乏有关。WE的标准治疗是静脉注射(IV)硫胺素,但有限的研究描述了最佳剂量。我们介绍了一例患有严重酒精使用障碍(AUD)和慢性营养不良的40岁男性,该男性患有WE。静脉注射100毫克硫胺素后,WE的症状持续存在,但是当剂量增加到500毫克时,精神状态改变和眼肌麻痹迅速解决。IV硫胺素是WE的可靠且低风险的治疗方法,即使是高剂量给药。高剂量静脉注射硫胺素(即,>/100mg)可以治疗WE中的神经症状和认知功能障碍,应考虑进行一线治疗。WE诊断和治疗指南的进一步研究是必要的,以最大限度地提高恢复潜力。