Thiamine: A Case Report on Wernicke Syndrome and Anorexia Nervosa

Anorexia nervosa (AN) is a severe eating disorder. Although Wernicke’s encephalopathy (WE) is frequently associated with alcohol abuse, non-alcoholic WE has been described in AN associated with malnutrition and refeeding syndrome. This work aims to present a case report of non-alcoholic WE associated with AN. A 27-year-old woman diagnosed with AN was admitted to the hospital for a low weight of 33 kg and body mass index of 12.9 kg/m2. The patient started a nutritional plan, and two weeks after, she presented a sudden onset of psychomotor slowing, disorganized behaviour, nocturnal enuresis and the need for feeding support. On evaluation, she also had a defect in attention and memory with confabulation. Due to the diagnostic hypothesis of metabolic encephalopathy, the patient started thiamine with progressive clinical improvement.AN carries a lethal risk associated with severe nutritional deficits and medical complications, so careful surveillance, assessment and early intervention are required.