Preventing Wernicke's encephalopathy in anorexia nervosa: A systematic review

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#anorexia-nervosa #humans #wernicke-encephalopathy

Preventing Wernicke's encephalopathy in anorexia nervosa: A systematic review

Oudman et al., 2018 | Psychiatry Clin Neurosci | Systematic Review

Citation

Oudman Erik, Wijnia Jan W, ... Postma Albert. Preventing Wernicke's encephalopathy in anorexia nervosa: A systematic review. Psychiatry Clin Neurosci. 2018-Oct;72(10):774-779. doi:10.1111/pcn.12735

Abstract

Anorexia nervosa (AN) is a common eating disorder that affects 2.9 million people worldwide. Not eating a balanced diet or fasting can cause neurological complications after severe vitamin B1 malnourishment, although the precise signs and symptoms of Wernicke's encephalopathy (WE) are not clear. Our aim was to review the signs and symptoms of WE in patients with AN. We searched MEDLINE, EMBASE, Scopus, and PiCarta on all case descriptions of WE following AN. All case descriptions of WE in AN, irrespective of language, were included. Twelve WE cases were reviewed, suggesting that WE following AN is still a relatively rare neuropsychiatric disorder. WE is characterized by a triad of: mental status change, ocular signs, and ataxia. In alcoholism, this triad is present in 16% of cases, but eight out of 12 AN cases presented themselves with a full triad of symptomatology. Importantly, patients often had a more complex triad than has been previously described, involving vertigo, diplopia, and the consequences of refeeding syndrome. The development of a full triad and additional symptomatology suggests a late recognition of signs and symptoms of WE in AN. A complicating factor is the overlap between symptoms of thiamine deficiency and the symptoms of WE. Specifically, patients who show rapid weight loss are vulnerable for the development of WE. Eating disorders, such as AN, can lead to WE. Prophylactic thiamine checks and treatment in patients with AN are relevant, and in case of suspicion of WE, adequate parenteral thiamine supplementation is necessary.

Key Findings

Prophylactic thiamine checks and treatment in patients with AN are relevant, and in case of suspicion of WE, adequate parenteral thiamine supplementation is necessary.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population an
Sample Size See abstract
Age Range See abstract
Condition deficiency

MeSH Terms

  • Anorexia Nervosa
  • Humans
  • Wernicke Encephalopathy

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: thiamine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09