[Wernicke's encephalopathy in chronic gastropancreatic disease with pyloric stenosis]

The acute symptomatology of Wernicke's syndrome was observed in a 17-year-old female patient and a 48-year-old male patient. They were both affected by chronic gastropancreatic disease with pyloric stenosis and showed already subclinical thiamine deficiency. Symptoms occurred within 4 weeks of an infusion regime rich in carbohydrates. Parenteral administration of high doses of thiamine (200 mg/d and 360 mg/d) led to clear-cut regression of symptoms. Due to the unfavourable prognosis of Wernicke's encephalopathy prophylactic administration of thiamine in a daily dosage of 50-100 mg is recommended in patients with chronic intestinal disease and parenteral nutrition.