硫胺素是核酸合成过程中必需的辅因子。神经元组织对硫胺素缺乏特别敏感,表现为韦尼克脑病(WE)。我们典型的三合会,脑病,眼球运动功能障碍和步态共济失调,仅在不到三分之一的病例中出现。我们介绍了由于假定的硫胺素缺乏症而导致的失眠症的中年男子的病例,住院时间延长,精神状态改变的原因被延迟诊断。这种疾病仅作为意识水平下降的表现并不常见,但已在文献中报道。必须认识到WE是一种可治疗的疾病,可能仅表现为活跃的谵妄。延误诊断和治疗可能导致昏迷和死亡。
Thiamine is an essential cofactor in the process of nucleic acid synthesis. Neuronal tissues are especially sensitive to thiamine deficiency, manifesting as Wernicke\'s encephalopathy (WE). The typical triad of WE, encephalopathy, oculomotor dysfunction and gait ataxia, is only present in less than one-third of the cases. We present the
case of a middle-aged man with hypoactive delirium due to presumed thiamine deficiency, who had a prolonged hospital course and a delayed diagnosis of the cause of altered mental status. The presentation of this disorder solely as a decreased level of consciousness is uncommon but has been reported in the literature. It is essential to recognise WE as a treatable condition that may manifest only as a hypoactive delirium. The delay in the diagnosis and treatment may lead to coma and death.