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Development of Wernicke encephalopathy in a terminally ill cancer patient consuming an adequate diet: A case report and review of the literature

Published online by Cambridge University Press:  13 April 2006

SUZU YAE ,
SHIGEKO OKUNO ,
HIDEKI ONISHI  and
CHIAKI KAWANISHI
SUZU YAE
Affiliation:
Department of Palliative Medicine, Kanagawa Cancer Center, Asahi-ku, Yokohama, Japan
SHIGEKO OKUNO
Affiliation:
Department of Palliative Medicine, Kanagawa Cancer Center, Asahi-ku, Yokohama, Japan
HIDEKI ONISHI
Affiliation:
Department of Psychiatry, Kanagawa Cancer Center, Asahi-ku, Yokohama, Japan
CHIAKI KAWANISHI
Affiliation:
Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
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Abstract

Malignancy-associated primary thiamine deficiency has been documented in several experimental tumors, clinical case reports, and in patients with fast growing malignancies. We report a terminally ill cancer patient who developed delirium. Close examination of the patient demonstrated that delirium was caused by thiamine deficiency, although she had been consuming an average of 990 cal/day for the past 3 weeks. Malabsorption or consumption by the tumor was considered the mechanism of thiamine deficiency. Early recognition and subsequent treatment resulted in successful palliation of delirium. In terminally ill cancer patients, clinicians must remain aware of the possibility of Wernicke's encephalopathy, when the patients develop unexplained delirium, even if the patient has been consuming adequate amounts of food. Early intervention may correct the symptoms and prevent irreversible brain damage, and the quality of life for the patient may improve.

Keywords

Vitamin B1 deficiencyCancerDelirium
Type
CASE REPORTS
Information
Palliative & Supportive Care , Volume 3 , Issue 4 , December 2005 , pp. 333 - 335
Copyright
© 2005 Cambridge University Press

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References

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