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Pediatric Wernicke Encephalopathy: A Systematic Review
Erik Oudman1,2, Jan W Wijnia1,2, Janice R Bidesie1,2
1Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands.
Pediatric Reports
|February 25, 2025
Summary
Pediatric Wernicke Encephalopathy (WE) can occur without alcohol. Early nausea and vomiting predict WE, and thiamine in parenteral nutrition is crucial for recovery, especially with optimal dosing.
Area of Science:
- Neurology
- Pediatrics
- Nutritional Science
Background:
- Wernicke Encephalopathy (WE) is a neurological disorder typically associated with alcohol use.
- Pediatric WE can arise from various non-alcoholic causes, including malnutrition and critical illnesses.
Purpose of the Study:
- To systematically review pediatric Wernicke Encephalopathy cases.
- To identify diverse etiologies and clinical presentations of pediatric WE.
- To evaluate diagnostic and treatment outcomes for pediatric WE.
Main Methods:
- Systematic review of 88 pediatric WE cases over 30 years.
- Analysis of etiologies including cancer, gastrointestinal diseases, malnutrition, and COVID-19.
- Review of clinical symptoms, diagnostic findings (MRI), and treatment protocols.
Main Results:
- Nausea (60%) and vomiting (55%) were common prodromal symptoms.
- 37% received parenteral nutrition without thiamine before diagnosis, risking progression to Wernicke-Korsakoff syndrome (WKS).
- Classic WKS triad (eye movement disorders, altered mental status, ataxia) present in most cases; MRI sensitivity 85%. Higher thiamine doses improved outcomes.
Conclusions:
- Early recognition of nausea and vomiting is key for predicting pediatric WE.
- Thiamine supplementation in parenteral nutrition is critical for preventing and treating pediatric WE.
- Optimal thiamine dosing is vital for patient recovery and improved outcomes.
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