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Malnutrition-induced Wernicke's encephalopathy following a water-only fasting diet.
Nutr Clin Pract. 2015 Feb; 30(1):92-9.NC

Abstract

BACKGROUND

Wernicke's encephalopathy is a critical condition of neurological dysfunction resulting from a deficiency in thiamine. Chronic alcoholism is recognized as the most common cause of Wernicke's encephalopathy, but other causes, including fasting/starvation and malnutrition, have been documented within the scientific literature. These causes may not be readily recognized by healthcare professionals and may lead to Wernicke's encephalopathy being overlooked as a diagnosis when a nonalcoholic patient presents with classic signs and symptoms of the disorder.

MATERIALS AND METHODS

A narrative review of thiamine and its relationship to the development, diagnosis, and treatment of Wernicke's encephalopathy is presented based on a review of evidence-based guidelines and published research. To heighten awareness of the development of Wernicke's encephalopathy in fasted/starved and malnourished patients and to contribute to the scientific body of knowledge for the identification and management of Wernicke's encephalopathy in these patients, the clinical course and treatment of an adult woman who developed Wernicke's encephalopathy following a 40-day water-only fasting diet is outlined.

RESULTS

Clinical suspicion was required to identify the patient's condition and initiate immediate intervention through parenteral thiamine administration. Oral thiamine supplementation of 100 to 800 mg per day for 6 months was required to aid recovery.

OUTCOMES

The patient's clinical course and response to treatment illustrate the necessity for clinical awareness and suspicion of Wernicke's encephalopathy among healthcare professionals, timely and adequate parenteral thiamine administration, and oral thiamine supplementation at therapeutic doses to correct the nutrient deficiency, halt the progression of Wernicke's encephalopathy, and promote recovery.

Authors+Show Affiliations

School of Health Related Professions, Department of Nutritional Sciences, Rutgers, The State University of New Jersey, Newark, New Jersey Department of Food, Nutrition, and Packaging Sciences, Clemson, University, Clemson, South Carolina hutcheda@shrp.rutgers.edu.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

25524882

Citation

Hutcheon, Deborah A.. "Malnutrition-induced Wernicke's Encephalopathy Following a Water-only Fasting Diet." Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, vol. 30, no. 1, 2015, pp. 92-9.
Hutcheon DA. Malnutrition-induced Wernicke's encephalopathy following a water-only fasting diet. Nutr Clin Pract. 2015;30(1):92-9.
Hutcheon, D. A. (2015). Malnutrition-induced Wernicke's encephalopathy following a water-only fasting diet. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 30(1), 92-9. https://doi.org/10.1177/0884533614561793
Hutcheon DA. Malnutrition-induced Wernicke's Encephalopathy Following a Water-only Fasting Diet. Nutr Clin Pract. 2015;30(1):92-9. PubMed PMID: 25524882.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Malnutrition-induced Wernicke's encephalopathy following a water-only fasting diet. A1 - Hutcheon,Deborah A, Y1 - 2014/12/18/ PY - 2014/12/20/entrez PY - 2014/12/20/pubmed PY - 2016/1/12/medline KW - Wernicke encephalopathy KW - avitaminosis KW - fasting KW - malnutrition KW - thiamine KW - thiamine deficiency SP - 92 EP - 9 JF - Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition JO - Nutr Clin Pract VL - 30 IS - 1 N2 - BACKGROUND: Wernicke's encephalopathy is a critical condition of neurological dysfunction resulting from a deficiency in thiamine. Chronic alcoholism is recognized as the most common cause of Wernicke's encephalopathy, but other causes, including fasting/starvation and malnutrition, have been documented within the scientific literature. These causes may not be readily recognized by healthcare professionals and may lead to Wernicke's encephalopathy being overlooked as a diagnosis when a nonalcoholic patient presents with classic signs and symptoms of the disorder. MATERIALS AND METHODS: A narrative review of thiamine and its relationship to the development, diagnosis, and treatment of Wernicke's encephalopathy is presented based on a review of evidence-based guidelines and published research. To heighten awareness of the development of Wernicke's encephalopathy in fasted/starved and malnourished patients and to contribute to the scientific body of knowledge for the identification and management of Wernicke's encephalopathy in these patients, the clinical course and treatment of an adult woman who developed Wernicke's encephalopathy following a 40-day water-only fasting diet is outlined. RESULTS: Clinical suspicion was required to identify the patient's condition and initiate immediate intervention through parenteral thiamine administration. Oral thiamine supplementation of 100 to 800 mg per day for 6 months was required to aid recovery. OUTCOMES: The patient's clinical course and response to treatment illustrate the necessity for clinical awareness and suspicion of Wernicke's encephalopathy among healthcare professionals, timely and adequate parenteral thiamine administration, and oral thiamine supplementation at therapeutic doses to correct the nutrient deficiency, halt the progression of Wernicke's encephalopathy, and promote recovery. SN - 1941-2452 UR - https://www.unboundmedicine.com/medline/citation/25524882/Malnutrition_induced_Wernicke's_encephalopathy_following_a_water_only_fasting_diet_ L2 - https://doi.org/10.1177/0884533614561793 DB - PRIME DP - Unbound Medicine ER -