췌십이지장절제술 후 발생한 지속적인 구토증과 Wernicke 뇌병증

• 영문명: Wernicke Encephalopathy in a Patient with Long-Standing Vomiting after Pancreatoduodenectomy
• 발행기관: 대한신경정신의학회
• 저자명: 박우영 김성완 이삼연 신일선 김재민 박기형 양수진 윤진상
• 간행물 정보: 『신경정신의학』제46권 제3호, 267~270쪽, 전체 4쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2007.05.30

영문 초록

Wernicke encephalopathy is an acute neurologic disorder attributable to thiamine (vitamin B1) deficiency. We report the case of a 61-year-old female patient who presented Wernicke encephalopathy after surgery for pancreatic head cancer. From the ninth postoperative day, she had suffered from nausea and vomiting and had difficulties ingesting food, she was given total parenteral nutrition (TPN), but lacked adequate vitamin (thiamine) supplementation. After 28 days, she developed ataxia, ophthalmoplegia, and mental confusion. The magnetic resonance image showed pathologic changes in the medial thalamus, periaqueductal gray matter, medulla and mamillary bodies. The blood level of thiamine was very low. After intravenous and oral supplementation of thiamine (200 mg/day), consciousness was soon normalized and neurologic symptoms have gradually been improving. Nausea and vomiting disappeared after administration of a low dose of mirtazapine (7.5 mg/day). We emphasize the importance of thiamine supplementation to the patients who suffer from vomiting which hinders them from taking food and who require prolonged TPN

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키워드

Wernicke encephalopathy Vomiting TPN Thiamine Mirtazapine