Saturday December 15, 2007
Wernicke's Encephalopathy in ICU

Q: Can Wernicke's Encephalopathy be iatrogenic in ICU ?

A: Yes, it can be precipitated in any patient by glucose (like D-5, D-10 or D-50) administration who is thiamine deficient. It is not limited to alcoholics and can happen in any nutritionally deficient patient. It is always a good idea to add thiamine in D-5 drip in patients who are at risk of Wernicke's Encephalopathy. Disorder was described about 25 years ago by Carl Wernicke as a triad of

• acute mental confusion
• ataxia
• opthalmoplegia

Read a case of Wernicke's encephalopathy. in a non-alcoholic patient with MRI findings here ( Ref.: The New England Journal of Medicine, Kaineg and Hudgins 352 (19): e18, May 12, 2005 )

Also see full review article Wernicke's encephalopathy at emedicine.com


Refrences: click to get abstract/article

1. Incidence and clinical consequences of purple glove syndrome in patients receiving intravenous phenytoin, Neurology, 1998:51:1034-1039.
2. A prospective study of the purple glove syndrome , Epilepsia, 2001:42(9):1156-1159.
3. Purple glove syndrome : A complication of intravenous phenytoin, J. of Neuroscience Nursing, 1992:24(8):340-345.
4. Purple glove syndrome: a complication of intravenous phenytoin. - J Neurosci Nurs.1992 Dec;24(6):340-5