Wernicke encephalopathy in a pediatric patient with cannabinoid hyperemesis: A novel case report

This case report details a novel case of Wernicke encephalopathy (WE) in a 16-year-old boy with obesity and chronic cannabis use. Despite the absence of alcohol use disorder, this adolescent developed classic symptoms of WE, challenging the conventional diagnostic framework. Clinical suspicion for WE was supported by typical magnetic resonance imaging findings, low thiamine levels and rapid clinical improvement postintravenous thiamine supplementation. This case underscores the need for heightened clinical vigilance for WE in patients who present with neurologic symptoms who endorse history of persistent emesis, regardless of their history of alcohol use. It also supports the preemptive administration of thiamine in those at risk of deficiency.