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A Case of Wernicke Encephalopathy Developing After Ileal Bypass Surgery

Kamaşak, Tülay, MD*; Kul, Sibel, MD; Tuşat, Mustafa, MD; Ozgun, Nezir, MD*; Cansu, Ali, MD*

doi: 10.1097/PEC.0000000000001472
Illustrative Cases

Wernicke encephalopathy is an acute neurological problem resulting from thiamine deficiency and manifesting with mental confusion, oculomotor dysfunction, and ataxia. It is associated with alcohol dependence in adults. Preparatory factors include hyperemesis gravidarum, prolonged diarrhea, prolonged parental nutrition without vitamin support, absorption disorders, anorexia, cancer, and chemotherapy. Failure to consider the clinical findings and preparatory factors of this disease, which is rare in children, can delay diagnosis. This report describes a case of Wernicke encephalopathy developing in a patient with brid ileus and receiving total parenteral nutrition after partial ileal bypass surgery. The patient's clinical and cranial magnetic resonance findings were compatible with Wernicke encephalopathy. Although these are not widespread, typical ocular findings for Wernicke encephalopathy were present. Dramatic improvements were observed in clinical, ocular, and cranial magnetic resonance findings after treatment.

From the Departments of *Pediatric Neurology,

Radiology, and

Pediatric Surgery, Karadeniz Teknik University, Trabzon, Turkey.

Disclosure: The authors declare no conflict of interest.

Reprints: Tülay Kamaşak, MD, Department of Pediatric Neurology, Karadeniz Teknik University, Trabzon, Turkey (e-mail: tkamasak@hotmail.com).

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