Wernicke's encephalopathy is a neuropsychiatric condition generally caused by acute thiamine deficiency. Although it is common in the severe alcoholics, several other causes also have been identified, such as total parenteral nutrition (TPN) use, persistent vomiting, hyperemesis gravidarum, anorexia nervosa and malnutrition. The classic triad of Wernicke's encephalopathy are ataxia, altered mentation and ophthalmoplegia. A 19-year-old boy had been treated with high dose Ara-C and mitoxantrone for acute myelogenous leukemia and intravenous hyperalimentation due to persistent vomiting. He suddenly complained of diplopia, gait disturbance and generalized weakness at 36th day after chemotherapy. Physical examinations showed disorientated mentality, oculomotor palsy and horizental nystagmus. The diagnosis of Wernicke's encephalopathy was made with classical brain MRI and decreased thiamine level. The patient was successfully treated with vitamin B1. We presented a case of acute Wernicke's encephalopathy developed after high dose Ara-C chemotherapy followed by intravenous hyperalimentation in a patient with acute myelogenous leukemia.
Alcoholics ; Anorexia Nervosa ; Ataxia ; Brain ; Cytarabine ; Diagnosis ; Diplopia ; Drug Therapy* ; Female ; Gait ; Humans ; Hyperemesis Gravidarum ; Leukemia, Myeloid, Acute ; Magnetic Resonance Imaging ; Male ; Malnutrition ; Mitoxantrone ; Ophthalmoplegia ; Paralysis ; Parenteral Nutrition ; Parenteral Nutrition, Total* ; Physical Examination ; Pregnancy ; Thiamine ; Thiamine Deficiency ; Vomiting ; Wernicke Encephalopathy* ; Young Adult