Vittorio Mantero1, Nicola Rifino2, Gisella Costantino2, Andrea Farina3, Ugo Pozzetti4, Monica Sciacco5, Michela Ripolone5, Graziella Bianchi2, Andrea Salmaggi2, Andrea Rigamonti2. 1. Neurology Unit, "A. Manzoni" Hospital-ASST Lecco, Via dell'Eremo 9/11, 23900, Lecco, Italy. vittorio.mantero@hotmail.com. 2. Neurology Unit, "A. Manzoni" Hospital-ASST Lecco, Via dell'Eremo 9/11, 23900, Lecco, Italy. 3. Cardiology Unit, "A. Manzoni" Hospital-ASST Lecco, Lecco, Italy. 4. Department of Internal Medicine, "A. Manzoni" Hospital-ASST Lecco, Lecco, Italy. 5. Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Abstract
INTRODUCTION: Nowadays, reports of beriberi are rare in developed countries. Wernicke encephalopathy may be present in about 25% of patients with beriberi. CASE REPORT: We report the case of a woman with history of depression and chronic eating disorder, who complained Wernicke encephalopathy and beriberi. Sural nerve and muscular biopsy were performed, showing severe axonal neuropathy. Thiamine supplementation was started with rapid improvement of the pulmonary and cardiac affections; improvement of peripheral neuropathy was incomplete. CONCLUSIONS: Thiamine deficiency can be misdiagnosed. Beriberi is an important cause of acute flaccid paralysis; hence, clinicians should consider this diagnosis and prompt start thiamine treatment to avoid permanent neurological sequelae.
INTRODUCTION: Nowadays, reports of beriberi are rare in developed countries. Wernicke encephalopathy may be present in about 25% of patients with beriberi. CASE REPORT: We report the case of a woman with history of depression and chronic eating disorder, who complained Wernicke encephalopathy and beriberi. Sural nerve and muscular biopsy were performed, showing severe axonal neuropathy. Thiamine supplementation was started with rapid improvement of the pulmonary and cardiac affections; improvement of peripheral neuropathy was incomplete. CONCLUSIONS:Thiamine deficiency can be misdiagnosed. Beriberi is an important cause of acute flaccid paralysis; hence, clinicians should consider this diagnosis and prompt start thiamine treatment to avoid permanent neurological sequelae.
Authors: Philip Heiser; Michael Teepker; J Carsten Möller; Frank M Theisen; Susan Friedel; Johannes Hebebrand; Helmut Remschmidt Journal: J Am Acad Child Adolesc Psychiatry Date: 2004-08 Impact factor: 8.829
Authors: Erik Oudman; Jan W Wijnia; Misha J Oey; Mirjam J van Dam; Albert Postma Journal: Psychiatry Clin Neurosci Date: 2018-07-31 Impact factor: 5.188