Wernicke's encephalopathy in a child with acute lymphoblastic leukemia

Am J Pediatr Hematol Oncol. 1993 Aug;15(3):331-4.


Purpose: We describe the case of a 9-year-old boy who developed Wernicke's encephalopathy while receiving chemotherapy for acute lymphoblastic leukemia (ALL).

Patients and methods: After suffering anorexia for 4 weeks following chemotherapy, he exhibited nystagmus and ataxia. Symptoms rapidly worsened following an increased glucose load, and included a depressed consciousness, irregular respiration, and ophthalmoplegia. The serum thiamine level was 9 ng/ml (normal: 20-50). Cranial computed tomography (CT) revealed a low density area bilaterally at the neostriatum. Thiamine 100 mg/day was administered intravenously.

Results: The patient's neurological signs improved dramatically. However, he subsequently developed pancytopenia and died of pneumonia.

Conclusion: The possibility of Wernicke's encephalopathy should be considered in children who are receiving chemotherapy for malignant disease when a persistent loss of appetite is followed by such neurological symptoms as nystagmus and ataxia.

Publication types

  • Case Reports

MeSH terms

  • Anorexia / chemically induced
  • Child
  • Humans
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Thiamine / therapeutic use
  • Thiamine Deficiency / etiology
  • Tomography, X-Ray Computed
  • Wernicke Encephalopathy / etiology*


  • Thiamine