Cargando…
Wernicke encephalopathy complicating catatonic schizophrenia
INTRODUCTION: Wernicke’s encephalopathy is a potentially fatal neurological emergency caused by thiamine deficiency. Although it is often associated with chronic alcoholism, it can also occur in all situations that lead to a thiamine deficiency such as undernutrition and exclusive artificial feeding...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9475653/ http://dx.doi.org/10.1192/j.eurpsy.2021.1399 |
_version_ | 1784789957414486016 |
---|---|
author | Rihab, C. Ellouze, S. Messedi, N. Turki, M. Ali, F. Ben Abid, W. Halouani, M. Aloulou, J. |
author_facet | Rihab, C. Ellouze, S. Messedi, N. Turki, M. Ali, F. Ben Abid, W. Halouani, M. Aloulou, J. |
author_sort | Rihab, C. |
collection | PubMed |
description | INTRODUCTION: Wernicke’s encephalopathy is a potentially fatal neurological emergency caused by thiamine deficiency. Although it is often associated with chronic alcoholism, it can also occur in all situations that lead to a thiamine deficiency such as undernutrition and exclusive artificial feeding. OBJECTIVES: In this work, we propose to study the clinical and treatment concerns of Wernicke’s encephalopathy complicating catatonic schizophrenia. METHODS: We retrospectively report the case of a patient who developed a Wernicke’s encephalopathy in the aftermath of catatonic schizophrenia. RESULTS: Mr H.L, a 47-year-old-male has been followed in psychiatric hospital since the age of 27 for catatonic schizophrenia. He has been hospitalized in July 2020 because of oral intake refusal, social isolation and lack of self-care with a poor compliance to treatment. Examination of the patient revealed catalepsy, mutism and negativism. He was treated with antipsychotics drugs, benzodiazepines and parenteral nutrition. About six weeks after his hospitalization, the patient developed horizontal nystagmus and ataxic gait. Magnetic resonance imaging was consistent with Wernicke encephalopathy. Vitamin B1 dosage was 32nmol/l. Parenteral thiamine replacement therapy was initiated with clinical improvement CONCLUSIONS: Catatonic schizophrenia can be associated with severe malnutrition and thus with thiamine deficiency and Wernicke’s encephalopathy. An early intervention by supplying prophylactic thiamine given parenterally in high-risk patients is crucial to avoid Korsakoff syndrome, as well as cardiovascular and neuropsychiatric complications associated with thiamine deficiency. |
format | Online Article Text |
id | pubmed-9475653 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-94756532022-09-29 Wernicke encephalopathy complicating catatonic schizophrenia Rihab, C. Ellouze, S. Messedi, N. Turki, M. Ali, F. Ben Abid, W. Halouani, M. Aloulou, J. Eur Psychiatry Abstract INTRODUCTION: Wernicke’s encephalopathy is a potentially fatal neurological emergency caused by thiamine deficiency. Although it is often associated with chronic alcoholism, it can also occur in all situations that lead to a thiamine deficiency such as undernutrition and exclusive artificial feeding. OBJECTIVES: In this work, we propose to study the clinical and treatment concerns of Wernicke’s encephalopathy complicating catatonic schizophrenia. METHODS: We retrospectively report the case of a patient who developed a Wernicke’s encephalopathy in the aftermath of catatonic schizophrenia. RESULTS: Mr H.L, a 47-year-old-male has been followed in psychiatric hospital since the age of 27 for catatonic schizophrenia. He has been hospitalized in July 2020 because of oral intake refusal, social isolation and lack of self-care with a poor compliance to treatment. Examination of the patient revealed catalepsy, mutism and negativism. He was treated with antipsychotics drugs, benzodiazepines and parenteral nutrition. About six weeks after his hospitalization, the patient developed horizontal nystagmus and ataxic gait. Magnetic resonance imaging was consistent with Wernicke encephalopathy. Vitamin B1 dosage was 32nmol/l. Parenteral thiamine replacement therapy was initiated with clinical improvement CONCLUSIONS: Catatonic schizophrenia can be associated with severe malnutrition and thus with thiamine deficiency and Wernicke’s encephalopathy. An early intervention by supplying prophylactic thiamine given parenterally in high-risk patients is crucial to avoid Korsakoff syndrome, as well as cardiovascular and neuropsychiatric complications associated with thiamine deficiency. Cambridge University Press 2021-08-13 /pmc/articles/PMC9475653/ http://dx.doi.org/10.1192/j.eurpsy.2021.1399 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Abstract Rihab, C. Ellouze, S. Messedi, N. Turki, M. Ali, F. Ben Abid, W. Halouani, M. Aloulou, J. Wernicke encephalopathy complicating catatonic schizophrenia |
title | Wernicke encephalopathy complicating catatonic schizophrenia |
title_full | Wernicke encephalopathy complicating catatonic schizophrenia |
title_fullStr | Wernicke encephalopathy complicating catatonic schizophrenia |
title_full_unstemmed | Wernicke encephalopathy complicating catatonic schizophrenia |
title_short | Wernicke encephalopathy complicating catatonic schizophrenia |
title_sort | wernicke encephalopathy complicating catatonic schizophrenia |
topic | Abstract |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9475653/ http://dx.doi.org/10.1192/j.eurpsy.2021.1399 |
work_keys_str_mv | AT rihabc wernickeencephalopathycomplicatingcatatonicschizophrenia AT ellouzes wernickeencephalopathycomplicatingcatatonicschizophrenia AT messedin wernickeencephalopathycomplicatingcatatonicschizophrenia AT turkim wernickeencephalopathycomplicatingcatatonicschizophrenia AT alifben wernickeencephalopathycomplicatingcatatonicschizophrenia AT abidw wernickeencephalopathycomplicatingcatatonicschizophrenia AT halouanim wernickeencephalopathycomplicatingcatatonicschizophrenia AT aloulouj wernickeencephalopathycomplicatingcatatonicschizophrenia |