Non-Alcoholic Gayet-Wernicke Encephalopathy in an Elderly Malnourished Patient: A Case Report and Review of Diagnostic and Therapeutic Approaches

Wernicke's encephalopathy results from a thiamine deficiency. It is an underdiagnosed pathology, particularly in the geriatric population, with irreversible consequences. We report a case of a Wernicke's encephalopathy in an elderly patient who was hospitalized for anorexia, in a context of inappropriate re-feeding. Neurological deterioration was observed following the instatement of parenteral nutrition. Brain MRI evidenced anomalies suggestive of Wernicke's encephalopathy. Intravenous treatment with thiamine provided an improvement in mental alertness, nevertheless contrasting with an aggravation of her cognitive disorders. This case illustrates the gravity of Wernicke's encephalopathy, which entails a risk of severe complications among elderly, malnourished patients. It is a diagnostic and therapeutic emergency.