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November 14, 1977

Wernicke's Encephalopathy: Complication of Intravenous Hyperalimentation

JAMA. 1977;238(20):2176-2177. doi:10.1001/jama.1977.03280210068028

ONE of the most dramatic presentations in clinical medicine is the syndrome of Wernicke's encephalopathy. Although the classic triad of confusion, ophthalmoplegia, and ataxia has been described in nonalcoholic patients with various gastrointestinal disorders and subsequent malnutrition, the recent literature would suggest that these cases are now rare. The diagnosis can be easily overlooked when the patient is in a group not usually suspected to develop the disorder. Such oversight can leave the patient with permanent and devastating neurologic deficits that might otherwise have been avoided by timely specific treatment. In a middle-aged, nonalcoholic woman, Wernicke's encephalopathy followed intravenous hyperalimentation without concomitant vitamin therapy.

Report of a Case  A 63-year-old woman was in good health until June 3, 1976, when she was admitted to another hospital after falling from a ladder. She was noted to be confused on admission and skull and spine roentgenograms disclosed a small basilar skull fracture