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Wernicke's encephalopathy in advanced cancer
Samantha Brown1, Suzanne Hutt-Williams2
1Palliative Medicine, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK samantha.brown@uhd.nhs.uk.
BMJ Supportive & Palliative Care
|July 13, 2022
Summary
Metastatic breast cancer can cause Wernicke's encephalopathy, a neurological condition. Prompt thiamine treatment led to symptom improvement in a patient with cancer-associated WE.
Area of Science:
- Neurology
- Oncology
- Internal Medicine
Background:
- Metastatic breast cancer can present with neurological complications.
- Wernicke's encephalopathy (WE) is a serious neurological condition often associated with alcohol misuse, but can occur in other contexts.
Observation:
- A 54-year-old woman with metastatic breast cancer developed severe confusion, incontinence, and self-neglect.
- Magnetic Resonance Imaging (MRI) suggested Wernicke's encephalopathy (WE), despite no history of alcohol misuse.
- Initial treatments for her condition were ineffective, and cancer progression was suspected as the cause.
Findings:
- The patient's symptoms eventually improved with thiamine therapy, indicating cancer-associated WE.
- This case highlights that WE can occur secondary to malignancy, independent of alcohol consumption.
Implications:
- Early recognition and treatment of WE are crucial, even in the absence of alcohol misuse.
- Thiamine supplementation should be considered in cancer patients presenting with neurological symptoms suggestive of WE.
- Specialist palliative care can play a vital role in managing complex cases and supporting patients discharged to nursing homes.
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