CLC number: R591.42+1
On-line Access: 2010-06-02
Received: 2010-01-11
Revision Accepted: 2010-04-22
Crosschecked: 2010-05-05
Cited: 4
Clicked: 6110
Xia-ping Zhang, Yuan-qiang Lu, Wei-dong Huang. Wernicke encephalopathy following splenectomy in a patient with liver cirrhosis: a case report and review of the literature[J]. Journal of Zhejiang University Science B, 2010, 11(6): 433-436.
@article{title="Wernicke encephalopathy following splenectomy in a patient with liver cirrhosis: a case report and review of the literature",
author="Xia-ping Zhang, Yuan-qiang Lu, Wei-dong Huang",
journal="Journal of Zhejiang University Science B",
volume="11",
number="6",
pages="433-436",
year="2010",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1000016"
}
%0 Journal Article
%T Wernicke encephalopathy following splenectomy in a patient with liver cirrhosis: a case report and review of the literature
%A Xia-ping Zhang
%A Yuan-qiang Lu
%A Wei-dong Huang
%J Journal of Zhejiang University SCIENCE B
%V 11
%N 6
%P 433-436
%@ 1673-1581
%D 2010
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1000016
TY - JOUR
T1 - Wernicke encephalopathy following splenectomy in a patient with liver cirrhosis: a case report and review of the literature
A1 - Xia-ping Zhang
A1 - Yuan-qiang Lu
A1 - Wei-dong Huang
J0 - Journal of Zhejiang University Science B
VL - 11
IS - 6
SP - 433
EP - 436
%@ 1673-1581
Y1 - 2010
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1000016
Abstract: Objective: To report a case of wernicke encephalopathy in the early stage after surgery. Methods: A nonalcoholic female patient with hepatitis B-related cirrhosis and hypersplenism underwent splenectomy in a local hospital. No surgical complications occurred and the patient recovered well. However, on the eighth postoperative day she developed psychiatric and neurological disturbance without an obvious cause. She was then admitted to our hospital. Brain magnetic resonance imaging (MRI) with FLAIR T2 showed symmetric high-signal intensities in the periaqueductal area of the midbrain, which were consistent with wernicke encephalopathy. She was thus given intramuscular thiamine immediately. Results: After the administration of thiamine, the patient’s confused mental state resolved within 3 d, and her dystaxia gradually improved over the next 5 d. The brain MRI with FLAIR T2 was re-examined one month after the episode, and showed nearly complete resolution of the previously abnormal signal intensities in the periaqueductal area of the midbrain. Conclusion: Physicians should be aware of the possibility of acute wernicke encephalopathy, especially in patients with liver dysfunction.
[1]Antunez, E., Estruch, R., Cardenal, C., Nicolas, J.M., Fernandez-Sola, J., Urbano-Marquez, A., 1998. Usefulness of CT and MR imaging in the diagnosis of acute Wernicke’s encephalopathy. American Journal of Roentgenology, 171(4):1131-1137.
[2]Attard, O., Dietemann, J.L., Diemunsch, P., Pottecher, T., Meyer, A., Calon, B.L., 2006. Wernicke encephalopathy: a complication of parenteral nutrition diagnosed by magnetic resonance imaging. Anesthesiology, 105(4):847-848.
[3]Bonucchi, J., Hassan, I., Policeni, B., Kaboli, P., 2008. Thyrotoxicosis associated Wernicke’s encephalopathy. Journal of General Internal Medicine, 23(1):106-109.
[4]Chiossi, G., Neri, I., Cavazzuti, M., Basso, G., Facchinetti, F., 2006. Hyperemesis gravidarum complicated by Wernicke encephalopathy: background, case report, and review of the literature. Obstetrical & Gynecological Survey, 61(4):255-268.
[5]Cho, I.J., Chang, H.J., Lee, K.E., Won, H.S., Choi, M.Y., Nam, E.M., Mun, Y.C., Lee, S.N., Seong, C.M., 2009. A case of Wernicke’s encephalopathy following fluorouracil-based chemotherapy. Journal of Korean Medical Science, 24(4):747-750.
[6]Doherty, M.J., Watson, N.F., Uchino, K., Hallam, D.K., Cramer, S.C., 2002. Diffusion abnormalities in patients with Wernicke encephalopathy. Neurology, 58(4):655-657.
[7]Hack, J.B., Hoffman, R.S., 1998. Thiamine before glucose to prevent Wernicke encephalopathy: examining conventional wisdom. The Journal of the American Medical Association, 279(8):583-584.
[8]Harrison, R.A., Vu, T., Hunter, A.J., 2006. Wernicke’s encephalopathy in a patient with schizophrenia. Journal of General Internal Medicine, 21(12):C8-C11.
[9]Koguchi, K., Nakatsuji, Y., Abe, K., Sakoda, S., 2004. Wernicke’s encephalopathy after glucose infusion. Neurology, 62(3):512.
[10]Loh, Y., Watson, W.D., Verma, A., Chang, S.T., Stocker, D.J., Labutta, R.J., 2004. Acute Wernicke’s encephalopathy following bariatric surgery: clinical course and MRI correlation. Obesity Surgery, 14(1):129-132.
[11]Merkin-Zaborsky, H., Ifergane, G., Frisher, S., Valdman, S., Herishanu, Y., Wirguin, I., 2001. Thiamine-responsive acute neurological disorders in nonalcoholic patients. European Neurology, 45(1):34-37.
[12]Ogershok, P.R., Rahman, A., Nestor, S., Brick, J., 2002. Wernicke encephalopathy in nonalcoholic patients. The American Journal of the Medical Sciences, 323(2):107-111.
[13]Onishi, H., Sugimasa, Y., Kawanishi, C., Onose, M., 2005. Wernicke encephalopathy presented in the form of postoperative delirium in a patient with hepatocellular carcinoma and liver cirrhosis: a case report and review of the literature. Palliative & Supportive Care, 3(4):337-340.
[14]Reuler, J.B., Girard, D.E., Cooney, T.G., 1985. Current concepts: Wernicke’s encephalopathy. The New England Journal of Medicine, 312(16):1035-1039.
[15]Sechi, G., Serra, A., 2007. Wernicke’s encephalopathy: new clinical settings and recent advances in diagnosis and management. The Lancet Neurology, 6(5):442-455.
Open peer comments: Debate/Discuss/Question/Opinion
<1>