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Wernicke's encephalopathy complicating schizophrenia

B Spittle1, J Parker

  • 1Department of Psychological Medicine, University of Otago Medical School, Dunedin, New Zealand.

The Australian and New Zealand Journal of Psychiatry
|December 1, 1993
PubMed
Summary
This summary is machine-generated.

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Malnourished psychiatric patients can develop Wernicke's encephalopathy, causing altered mental states. Prompt thiamine administration is crucial for recovery, even without alcohol use.

Area of Science:

  • Neurology
  • Psychiatry
  • Nutritional Science

Background:

  • Wernicke's encephalopathy (WE) is a serious neurological condition often associated with alcohol abuse.
  • However, WE can also occur in malnourished individuals with psychiatric disorders due to inadequate thiamine intake.
  • Altered mental status in psychiatric patients necessitates consideration of nutritional deficiencies.

Observation:

  • A case of a 61-year-old woman with schizophrenia is presented.
  • She exhibited self-neglect, refusing medication and nutrition for four months, leading to a mute, unresponsive state and coma.
  • Her condition rapidly improved within three hours of thiamine administration.

Findings:

  • The patient's coma and unresponsiveness were directly linked to severe thiamine deficiency, a manifestation of Wernicke's encephalopathy.

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  • The neurological symptoms were reversible with prompt parenteral thiamine treatment.
  • This case highlights that WE can occur in non-alcoholic, malnourished psychiatric patients.

    • Implications:

    • Clinicians must maintain a high index of suspicion for WE in any malnourished patient presenting with altered mental status, irrespective of alcohol consumption.
    • Early recognition and treatment with thiamine are critical to prevent irreversible neurological damage.
    • Diagnostic uncertainty regarding WE warrants empirical parenteral thiamine administration.