Apathetic encephalopathy in thyreotoxicosis: an unsual cause of wernicke encephalopathy and osmotic demyelinating syndrome: An unsual cause of wernicke encephalopathy and osmotic demyelinating syndrome

Carlotta Mutti; Rosario Ciliento; Liborio Parrino; Irene Florindo; Giovanni Pavesi; Lucia Zinno

doi:10.23750/abm.v92i1.9473

Apathetic encephalopathy in thyreotoxicosis: an unsual cause of wernicke encephalopathy and osmotic demyelinating syndrome

An unsual cause of wernicke encephalopathy and osmotic demyelinating syndrome

Authors

Carlotta Mutti Neurology Department, Parma Hospital
Rosario Ciliento Neurology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
Liborio Parrino Sleep Medicine Center, Neurology Unit, Department of General and Specialistic Medicine, University Hospital of Parma, Parma, Italy
Irene Florindo Neurology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
Giovanni Pavesi Neurology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
Lucia Zinno Neurology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy

Keywords:

Apathetic Encephalopathy, Thyrotoxicosis Wernicke encephalopathy, osmotic demyelination syndrome

Abstract

Non-alcoholic Wernicke Encephalopathy (WE) is an overlooked complication of malnourishment in all its forms including undernutrition, inadequate vitamine intake and endocrinological diseases. Both delay in treatment and overtreatment can lead to severe neurological life-long consequences. Inadequate management in patients with chronic malnutrition may cause abrupt osmolytes unbalance and subsequent osmotic demyelination syndromes. We describe a 65-year old man with apathetic encephalopathy caused by thyreotoxicosis and associated with malnutrition and severe thiamine depletion.

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