[Encephalopathy with pure nicotinic acid deficiency in alcoholic patients. Two cases, with anatomoclinical study in...

Two chronic alcoholic patients developed severe encephalopathy while receiving high doses of parenteral thiamine and pyridoxine. Both presented with unusually marked hypertonia of the gegenhalten type, myoclonias and fluctuating mental impairment with memory disturbances and hallucinations. Later on, one patient went into stupor and coma and died ; the other recovered after parenteral niacin treatment. No skin lesions or diarrhoea were observed. Post-mortem examination of the first patient confirmed the presence of a pellagra-like encephalopathy characterized by widespread neuronal chromatolysis. There were no changes suggesting an associated alcoholic encephalopathy.