Pediatric non-alcoholic Wernicke’s encephalopathy: a case report

Abstract Wernicke-Korsakoff syndrome is a neurological disorder caused by thiamine (vitamin B1) deficiency. This encephalopathy is typically suspected in alcoholics adults, but it is important to remember that other less known and suspected causes can determine the development of the non-alcoholic W...

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Main Authors: Lucia Corso, Laura Lucaccioni, Martina Buttera, Mattia De Agostini, Patrizia Bergonzini, Elisabetta Spezia, Elisa Caramaschi, Diego Biondini, Viviana Durante, Lorenzo Iughetti, Barbara Predieri
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Italian Journal of Pediatrics
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Online Access:https://doi.org/10.1186/s13052-025-02022-7
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author Lucia Corso
Laura Lucaccioni
Martina Buttera
Mattia De Agostini
Patrizia Bergonzini
Elisabetta Spezia
Elisa Caramaschi
Diego Biondini
Viviana Durante
Lorenzo Iughetti
Barbara Predieri
author_facet Lucia Corso
Laura Lucaccioni
Martina Buttera
Mattia De Agostini
Patrizia Bergonzini
Elisabetta Spezia
Elisa Caramaschi
Diego Biondini
Viviana Durante
Lorenzo Iughetti
Barbara Predieri
author_sort Lucia Corso
collection DOAJ
description Abstract Wernicke-Korsakoff syndrome is a neurological disorder caused by thiamine (vitamin B1) deficiency. This encephalopathy is typically suspected in alcoholics adults, but it is important to remember that other less known and suspected causes can determine the development of the non-alcoholic Wernicke’s encephalopathy. In non-alcoholic patients, the primary causes of Wernicke’s encephalopathy include hyperemesis gravidarum, restrictive diets and malnutrition, cancer, post-operative complications following bariatric surgery. Few data are reported regarding non-alcoholic thiamine deficiency, especially within the paediatric population. We describe the case of an 11-year-old Caucasian male with obesity who experienced prolonged emesis after the beginning of a strictly hypocaloric dietary regimen. This resulted in biliary colic episodes and subsequent necessity for cholecystectomy. The day after surgery, the patient developed acute visual impairment, horizontal nystagmus and diplopia, which were attributed to thiamine deficiency. Wernicke’s encephalopathy was suspected, so a blood sample was immediately collected to assay thiamine levels and empiric thiamine supplementation was started. Already from the day after the beginning of the treatment, the patient showed a significant improvement in his clinical conditions. This case study delineates clinical presentation, diagnosis, and treatment of our patient and provides information regarding the red-flag risk factors of non-alcoholic Wernicke’s encephalopathy in children. The aim is to increase the likelihood of suspecting the diagnosis and to promptly start the therapy, which is both simple and lifesaving.
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spelling doaj-art-3135a69c769043deb2df7a32e4f4b49e2025-08-20T03:46:21ZengBMCItalian Journal of Pediatrics1824-72882025-07-015111610.1186/s13052-025-02022-7Pediatric non-alcoholic Wernicke’s encephalopathy: a case reportLucia Corso0Laura Lucaccioni1Martina Buttera2Mattia De Agostini3Patrizia Bergonzini4Elisabetta Spezia5Elisa Caramaschi6Diego Biondini7Viviana Durante8Lorenzo Iughetti9Barbara Predieri10Postgraduate School of Paediatrics, University of Modena and Reggio EmiliaPostgraduate School of Paediatrics, University of Modena and Reggio EmiliaPostgraduate School of Paediatrics, University of Modena and Reggio EmiliaPostgraduate School of Paediatrics, University of Modena and Reggio EmiliaPaediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio EmiliaPaediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio EmiliaPaediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio EmiliaSurgical Paediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of ModenaSurgical Paediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of ModenaPostgraduate School of Paediatrics, University of Modena and Reggio EmiliaPostgraduate School of Paediatrics, University of Modena and Reggio EmiliaAbstract Wernicke-Korsakoff syndrome is a neurological disorder caused by thiamine (vitamin B1) deficiency. This encephalopathy is typically suspected in alcoholics adults, but it is important to remember that other less known and suspected causes can determine the development of the non-alcoholic Wernicke’s encephalopathy. In non-alcoholic patients, the primary causes of Wernicke’s encephalopathy include hyperemesis gravidarum, restrictive diets and malnutrition, cancer, post-operative complications following bariatric surgery. Few data are reported regarding non-alcoholic thiamine deficiency, especially within the paediatric population. We describe the case of an 11-year-old Caucasian male with obesity who experienced prolonged emesis after the beginning of a strictly hypocaloric dietary regimen. This resulted in biliary colic episodes and subsequent necessity for cholecystectomy. The day after surgery, the patient developed acute visual impairment, horizontal nystagmus and diplopia, which were attributed to thiamine deficiency. Wernicke’s encephalopathy was suspected, so a blood sample was immediately collected to assay thiamine levels and empiric thiamine supplementation was started. Already from the day after the beginning of the treatment, the patient showed a significant improvement in his clinical conditions. This case study delineates clinical presentation, diagnosis, and treatment of our patient and provides information regarding the red-flag risk factors of non-alcoholic Wernicke’s encephalopathy in children. The aim is to increase the likelihood of suspecting the diagnosis and to promptly start the therapy, which is both simple and lifesaving.https://doi.org/10.1186/s13052-025-02022-7Wernicke encephalopathyPaediatricThiamine deficiencyNystagmusGallstoneCase report
spellingShingle Lucia Corso
Laura Lucaccioni
Martina Buttera
Mattia De Agostini
Patrizia Bergonzini
Elisabetta Spezia
Elisa Caramaschi
Diego Biondini
Viviana Durante
Lorenzo Iughetti
Barbara Predieri
Pediatric non-alcoholic Wernicke’s encephalopathy: a case report
Italian Journal of Pediatrics
Wernicke encephalopathy
Paediatric
Thiamine deficiency
Nystagmus
Gallstone
Case report
title Pediatric non-alcoholic Wernicke’s encephalopathy: a case report
title_full Pediatric non-alcoholic Wernicke’s encephalopathy: a case report
title_fullStr Pediatric non-alcoholic Wernicke’s encephalopathy: a case report
title_full_unstemmed Pediatric non-alcoholic Wernicke’s encephalopathy: a case report
title_short Pediatric non-alcoholic Wernicke’s encephalopathy: a case report
title_sort pediatric non alcoholic wernicke s encephalopathy a case report
topic Wernicke encephalopathy
Paediatric
Thiamine deficiency
Nystagmus
Gallstone
Case report
url https://doi.org/10.1186/s13052-025-02022-7
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