A case of Wernicke's encephalopathy following fluorouracil-based chemotherapy

J Korean Med Sci. 2009 Aug;24(4):747-50. doi: 10.3346/jkms.2009.24.4.747. Epub 2009 Jul 30.


The pyrimidine antimetabolite 5-fluorouracil (5-FU) is a chemotherapeutic agent used widely for various tumors. Common side effects of 5-FU are related to its effects on the bone marrow and gastrointestinal epithelium. Neurotoxicity caused by 5-FU is uncommon, although acute and delayed forms have been reported. Wernicke's encephalopathy is an acute, neuropsychiatric syndrome resulting from thiamine deficiency, and has significant morbidity and mortality. Central nervous system neurotoxicity such as Wernicke's encephalopathy following chemotherapy with 5-FU has been reported rarely, although it has been suggested that 5-FU can produce adverse neurological effects by causing thiamine deficiency. We report a patient with Wernicke's encephalopathy, reversible with thiamine therapy, associated with 5-FU-based chemotherapy.

Keywords: Fluorouracil; Thiamine; Wernicke's Encephalopathy.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Antimetabolites, Antineoplastic / adverse effects*
  • Female
  • Fluorouracil / adverse effects*
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Nasopharyngeal Neoplasms / drug therapy
  • Nasopharyngeal Neoplasms / radiotherapy
  • Thiamine / therapeutic use
  • Thiamine Deficiency / complications*
  • Thiamine Deficiency / diagnosis
  • Wernicke Encephalopathy / chemically induced*
  • Wernicke Encephalopathy / diagnosis


  • Antimetabolites, Antineoplastic
  • Fluorouracil
  • Thiamine