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Early diagnosis of pediatric Wernicke's encephalopathy.
Pediatr Neurol. 1999 Apr; 20(4):289-94.PN

Abstract

Wernicke's encephalopathy may be fatal if untreated. Because Wernicke's encephalopathy is suspected to be underdiagnosed in children, the authors wished to assess the frequency of overlooked diagnosis and to establish pertinent findings that could lead to early identification of pediatric Wernicke's encephalopathy. The authors performed multiple literature searches seeking pediatric patients with Wernicke's encephalopathy (age = 20 years or younger). A total of 30 patients was found, and the authors added a new patient. Each case report had its clinical, radiologic, and laboratory data, diagnostic method, and outcome analyzed. Of 31 patients, 16 were female and 15 male; the median age +/- S.D. was 11 +/- 6.5 years. The most frequent underlying disorder was malignancy in 11. Thirteen patients died undiagnosed, 16 recovered with thiamine therapy (eight with sequelae), and two died of infection soon after thiamine replacement was initiated. Only six presented with the Wernicke's encephalopathy clinical triad (mental status changes, ocular signs, and ataxia) at neurologic onset; nine eventually demonstrated this triad. The high rate of patients diagnosed only at postmortem examination (41.9%) confirms that Wernicke's encephalopathy is underdiagnosed in children. Thiamine therapy is warranted if any component of the Wernicke's encephalopathy triad is present in an appropriate clinical setting.

Authors+Show Affiliations

Department of Pediatrics, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

10328278

Citation

Vasconcelos, M M., et al. "Early Diagnosis of Pediatric Wernicke's Encephalopathy." Pediatric Neurology, vol. 20, no. 4, 1999, pp. 289-94.
Vasconcelos MM, Silva KP, Vidal G, et al. Early diagnosis of pediatric Wernicke's encephalopathy. Pediatr Neurol. 1999;20(4):289-94.
Vasconcelos, M. M., Silva, K. P., Vidal, G., Silva, A. F., Domingues, R. C., & Berditchevsky, C. R. (1999). Early diagnosis of pediatric Wernicke's encephalopathy. Pediatric Neurology, 20(4), 289-94.
Vasconcelos MM, et al. Early Diagnosis of Pediatric Wernicke's Encephalopathy. Pediatr Neurol. 1999;20(4):289-94. PubMed PMID: 10328278.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early diagnosis of pediatric Wernicke's encephalopathy. AU - Vasconcelos,M M, AU - Silva,K P, AU - Vidal,G, AU - Silva,A F, AU - Domingues,R C, AU - Berditchevsky,C R, PY - 1999/5/18/pubmed PY - 1999/5/18/medline PY - 1999/5/18/entrez SP - 289 EP - 94 JF - Pediatric neurology JO - Pediatr Neurol VL - 20 IS - 4 N2 - Wernicke's encephalopathy may be fatal if untreated. Because Wernicke's encephalopathy is suspected to be underdiagnosed in children, the authors wished to assess the frequency of overlooked diagnosis and to establish pertinent findings that could lead to early identification of pediatric Wernicke's encephalopathy. The authors performed multiple literature searches seeking pediatric patients with Wernicke's encephalopathy (age = 20 years or younger). A total of 30 patients was found, and the authors added a new patient. Each case report had its clinical, radiologic, and laboratory data, diagnostic method, and outcome analyzed. Of 31 patients, 16 were female and 15 male; the median age +/- S.D. was 11 +/- 6.5 years. The most frequent underlying disorder was malignancy in 11. Thirteen patients died undiagnosed, 16 recovered with thiamine therapy (eight with sequelae), and two died of infection soon after thiamine replacement was initiated. Only six presented with the Wernicke's encephalopathy clinical triad (mental status changes, ocular signs, and ataxia) at neurologic onset; nine eventually demonstrated this triad. The high rate of patients diagnosed only at postmortem examination (41.9%) confirms that Wernicke's encephalopathy is underdiagnosed in children. Thiamine therapy is warranted if any component of the Wernicke's encephalopathy triad is present in an appropriate clinical setting. SN - 0887-8994 UR - https://www.unboundmedicine.com/medline/citation/10328278/Early_diagnosis_of_pediatric_Wernicke's_encephalopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0887-8994(98)00153-2 DB - PRIME DP - Unbound Medicine ER -