Five days after the initiation of a 20% dextrose infusion he developed nystagmus, bilateral sixth nerve palsies, areflexia, hypotension, and disorientation. The fourth patient, a 36-year-old alcoholic man, developed renal failure secondary to rhabdomyolysis and required hemodialysis. Based on our findings, a delay in giving glucose to hypoglycemic patients cannot be recommended at this time, although prompt thiamine supplementation. Her peritoneal dialysis fluid was switched to hypertonic glucose 48 hours prior to the development of disorientation, nystagmus, and a sixth nerve palsy. CONCLUSIONS: Mounting case report evidence suggests that prolonged glucose supplementation without the addition of thiamine can be a risk factor for the development of Wernicke encephalopathy. The third patient was a 45-year-old woman with end-stage renal failure who began peritoneal dialysis and lost 6.3 kg in 6 months. In particular, alcoholics with any of the signs of Wernicke's syndrome must receive thiamine before they are given glucose. As thiamin is an essential co-factor in carbohydrate. Scott said at a psychopharmacology conference sponsored by the University of Arizona. The body needs thiamin to convert carbohydrates into glucose, the main source of energy in the body. After 2 L of dextrose, she developed bilateral sixth nerve palsies, disorientation, and coma. Give an immediate parenteral dose of thiamine at the first sign of Wernicke's syndrome, Dr. The second patient was a 79-year-old woman with schizophrenia, anorexia, weight loss, horizontal nystagmus, absent deep tendon reflexes, and a temperature of 33☌ the diagnosis was septicemia.
After treatment with 3 L of 5% dextrose for more than 24 hours, her symptoms worsened. As with all medications and supplements, check with your health care provider before giving vitamin B1 supplements to a child. She had tachycardia, confusion, ataxia, absent deep tendon reflexes, and horizontal nystagmus. 2 The first was a 27-year-old woman with weight loss for more than 6 months, gastrointestinal symptoms for 3 days, and the onset of dizziness and blurring of her vision. acts as a co-enzyme in carbohydrate metabolism through the decarboxylation of alpha ketoacids co-enzyme for transketolase in pentose monophosphate pathway (. To the Editor.-In his letter, Dr Marinella 1 claims, "Thiamine should be administered prior to a glucose load because cases of Wernicke encephalopathy have been reported after glucose administration in thiamine-deficient patients." The reference that supports this statement describes only 4 patients.