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Wernicke's encephalopathy in advanced gastric cancer

 Eun Suk Jung  ;  Obin Kwon  ;  Soo Hyun Lee  ;  Ki Byung Lee  ;  Joo Hoon Kim  ;  Sang Hyun Yoon  ;  Gun Min Kim  ;  Hei-Cheul Jeung  ;  Sun Young Rha 
 CANCER RESEARCH AND TREATMENT, Vol.42(2) : 77-81, 2010 
Journal Title
Issue Date
Advanced gastric cancer ; Thiamine ; Wernicke's encephalopathy
PURPOSE: With their prolonged survival and malnutrition, cancer patients, and especially gastrointestinal (GI) tract cancer patients, can develop Wernicke's encephalopathy (WE). The aim of this study is to remind physicians of the importance of WE and prompt management in patients with GI tract cancer.

MATERIALS AND METHODS: This study is a retrospective review of 2 cases of WE in advanced gastric cancer (AGC) patients, and we review the literature for cases of GI tract cancer related to WE.

RESULTS: A 48-year-old female with AGC presented dizziness and diplopia for 5 days and a 20 kg weight loss. Neurologic exam showed nystagmus and gaze disturbance. Her symptoms improved after daily parenteral injection of thiamine 100 mg for 17 days. A 58-year-old female with AGC presented with sudden disorientation, confusion and 15 kg weight loss. Neurologic exam showed gaze limitation and mild ataxia. Despite daily parenteral injection of thiamine 100 mg for 4 days, she died 5 days after the onset of neurologic symptoms. Combining the cases noted in the literature review with our 2 cases, the 7 gastric cancer cases and 2 colorectal cancer cases related to WE showed similar clinical characteristics; 1) a history of long-period malnutrition and weight loss, 2) relatively typical neurologic signs and symptoms and 3) specific magnetic resonance image findings. Except for 2 patients who had irreversible neurologic symptoms, the other 7 patients were improved with prompt thiamine treatment.

CONCLUSION: It is important to consider WE in GI tract cancer patients with acute neurologic symptoms and who are in a state of malnutrition. Thiamine should be given as soon as possible when WE is suspected.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gun Min(김건민) ORCID logo https://orcid.org/0000-0001-9167-8682
Kim, Joo Hoon(김주훈)
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Yoon, Sang Hyun(윤상현)
Lee, Soo Hyeon(이수현)
Jung, Eun Suk(정은석)
Jeung, Hei Cheul(정희철) ORCID logo https://orcid.org/0000-0003-0952-3679
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