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Prolonged hypotension associated with Wernicke's encephalopathy
H Maeda1, A Kuriyama2, T Tanaka3
1Department of Emergency Medicine, Kurashiki Central Hospital, Kurashiki, Japan.
European Journal of Clinical Nutrition
|September 14, 2017
Summary
Wernicke
Area of Science:
- Neurology
- Internal Medicine
- Cardiology
Background:
- Wernicke's encephalopathy (WE) diagnosis can be challenging.
- Hypotension is a rare but reported complication of WE.
- Alcohol abuse is a common risk factor for WE.
Observation:
- A 69-year-old male with alcohol abuse presented with prolonged hypotension.
- The patient experienced 9 days of unremitting hypotension requiring vasopressor support.
- Signs of dysautonomia, including postural blood pressure fluctuations and bradycardia, were noted.
Findings:
- Despite thiamine treatment, the patient exhibited persistent hypotension.
- The clinical presentation suggested a significant association between dysautonomia and WE.
- This case highlights a prolonged hypotensive episode linked to WE and dysautonomia.
Implications:
- This case suggests a potential link between hypotension, dysautonomia, and Wernicke's encephalopathy.
- Clinicians should consider WE in patients with unexplained hypotension and dysautonomia, especially with a history of alcohol abuse.
- Further research is warranted to explore the pathophysiology and management of this association.
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