Wernicke's encephalopathy after chemotherapy

Background. - Wernicke's encephalopathy is usually seen in alcoholic adults. It is rare in childhood and usually discovered in a context of several pathological events. We report here a typical case of a teenager. Case report. - A 15-year-old girl with acute leukemia was given chemotherapy that resulted in profound aplasia and serious infection. She exhibited abnormal eye movements, ataxia, lethargy, enuresis and amnesia. MR examination showed T2-weighted images with increased signal in the thalami (pulvinar) and periaqueducal region. The symptoms improved dramatically with thiamine therapy. Omission of the usual vitamin supplementation between the courses of chemotherapy was responsible for this encephalopathy. Conclusion. - Thiamine deficiency can lead to death or amnesia. Rapid efficacy of vitamin supplementation helps diagnosis and prevents sequelae.