Purpose: To describe a case of Wernicke's encephalopathy in a 15-year-old female patient with anorexia nervosa--restricting type.
Method: The patient and family were interviewed. Literature relevant to the case was reviewed prior to diagnosis.
Results: The patient reported a 30-kg weight loss over a 6-month period, following a strict diet deplete in thiamine without vitamin supplementation. The patient reported a carbohydrate binge for 5 days prior to admission. Her clinical presentation, confusion, ataxia, nystagmus, and magnetic resonance imaging demonstrating bilateral subthalamic hyperdensities were consistent with Wernicke's encephalopathy. Nutritional stabilization and parenteral thiamine replacement resulted in rapid improvement of her ataxia and nystagmus and contributed to her recovery.
Conclusions: Wernicke's encephalopathy should be considered in patients with anorexia nervosa. Thiamine therapy could be considered in cases of anorexia nervosa with significant confusion.