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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...

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Autores principales: Rihab, C., Ellouze, S., Messedi, N., Turki, M., Ali, F. Ben, Abid, W., Halouani, M., Aloulou, J.
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
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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.
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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
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