Non-alcoholic Wernicke encephalopathy presenting as bilateral hearing loss: a case report
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Wernicke encephalopathy (WE) is a syndrome caused by thiamine deficiency whose main clinical features are ophthalmoplegia, ataxia, and altered mental state. This symptom triad can be incomplete, especially in the first few weeks from the onset . WE is typically described as complication of a long-standing history of alcohol abuse, but there is an increase of non-alcoholic cases, mainly due to iatrogenic causes .
Here, we report a case of iatrogenic WE in a patient presenting with sudden bilateral deafness 2 months after bariatric surgery.
A 27-year-old-man was admitted to the emergency room (ER) with rapidly progressing bilateral hearing loss followed by balance disturbance and diplopia. Bilateral hypoacusis started few days before and was initially misdiagnosed as otitis media. His relatives reported sleeve gastrectomy approximately 2 months before, followed by recurrent vomiting, and poor compliance with supplementation dietary prescribed after surgery.
LP: consulting fees from Biogen, Novartis and Roche; speaker honoraria from Biogen, Genzyme, Merck Serono, Novartis and Teva; travel grants from Biogen, Genzyme, Novartis and Teva; research grants from the Italian MS Society (Associazione Italiana Sclerosi Multipla) and Genzyme. CT: honoraria for speaking and travel grant from Biogen, Sanofi-Aventis, Merck Serono, Bayer-Schering, Teva, Genzyme, Almirall and Novartis. AS, GG, CG: none declared.
Compliance with ethical standards
The patient provided informed oral and written consent in accordance with specific national laws and the ethics standards laid down in the 1964 Declaration of Helsinki and its later amendments.
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