OBJECTIVE: To report a case of Wernicke encephalopathy associated with Crohn disease in childhood. CASE DESCRIPTION: A five year-old boy with Crohn disease, diagnosed by colonoscopy and biopsy one year ago; he has been treated with many different medications without results. During the past year, the patient was diagnosed with pancreatites and has received parenteral nutrition since then. After three months, the child suddenly presented drowsiness, meaningless speech and ocular movement disturbance. Neurologic examination disclosed upbeat nystagmus in all positions and horizontal nystagmus during conjugate deviation of the eyes. Magnetic resonance showed abnormalities consistent with Wernicke encephalopathy. Parenteral thiamine has been administered soon after diagnosis and by the 30th day of treatment, recovery of symptoms was complete. COMMENTS: Despite being a rare entity, neurological symptoms associated to the presence of risk factors such as prolonged parenteral nutrition should suggest Wernicke encephalopathy. Immediate treatment is important to avoid neurological disabilities.
Wernicke encephalopathy; Crohn disease; child; thiamine; parenteral nutrition
