Andrew Nishimoto1,2, Justin Usery1,2, John C Winton3, Jennifer Twilla4,2. 1. Department of Pharmacy, Methodist University Hospital, Memphis, TN, U.S.A. 2. Department of Clinical Pharmacy, University of Tennessee, Memphis, TN, U.S.A. 3. Inpatient Physicians, Methodist Germantown Hospital, Memphis, TN, U.S.A. 4. Department of Pharmacy, Methodist University Hospital, Memphis, TN, U.S.A. Jennifer.Twilla@mlh.org.
Abstract
BACKGROUND: Thiamine deficiency can lead to Wernicke's encephalopathy (WE), an acute and potentially life-threatening neurological disorder. Even though the main treatment modality for WE consists of thiamine replacement, evidence supporting an optimal dosing strategy and duration is unclear. PATIENTS AND METHODS: We present a single-center case series of eleven patients that were admitted with possible WE and treated with high-dose parenteral thiamine. RESULTS: Patients with suspected WE were treated with ≥500 mg intravenous thiamine for a median of 3 days with 73% of patients (eight out of eleven) displaying symptom resolution or improvement after treatment. No significant correlation between symptom resolution and timing of high-dose thiamine initiation (median=92 h) was identified. In patients whose symptoms resolved compared to those whose symptoms did not, there were no differences in patient variables nor adverse effects related to thiamine treatment. CONCLUSION: High-dose thiamine (≥500 mg) appears safe and efficacious for use in patients with suspected WE. Copyright
BACKGROUND:Thiamine deficiency can lead to Wernicke's encephalopathy (WE), an acute and potentially life-threatening neurological disorder. Even though the main treatment modality for WE consists of thiamine replacement, evidence supporting an optimal dosing strategy and duration is unclear. PATIENTS AND METHODS: We present a single-center case series of eleven patients that were admitted with possible WE and treated with high-dose parenteral thiamine. RESULTS:Patients with suspected WE were treated with ≥500 mg intravenous thiamine for a median of 3 days with 73% of patients (eight out of eleven) displaying symptom resolution or improvement after treatment. No significant correlation between symptom resolution and timing of high-dose thiamine initiation (median=92 h) was identified. In patients whose symptoms resolved compared to those whose symptoms did not, there were no differences in patient variables nor adverse effects related to thiamine treatment. CONCLUSION: High-dose thiamine (≥500 mg) appears safe and efficacious for use in patients with suspected WE. Copyright
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