# Non-alcoholic Wernicke’s Encephalopathy Masquerading As CNS Relapse of Acute Myeloid Leukemia

## TL;DR

A young man with leukemia showed symptoms of Wernicke's encephalopathy, a condition usually linked to alcoholism, but caused here by thiamine deficiency from chemotherapy.

## Contribution

Highlights WE as a non-alcoholic complication in leukemia patients undergoing chemotherapy, emphasizing thiamine supplementation.

## Key findings

- A non-alcoholic AML patient developed WE symptoms consistent with thiamine deficiency.
- Thiamine treatment improved visual and mental symptoms in the patient.
- WE should be considered in non-alcoholic patients with nutritional deficiencies during chemotherapy.

## Abstract

While Wernicke's encephalopathy (WE) is mostly caused by thiamine deficiency secondary to chronic alcohol use, other conditions that may affect one’s nutritional status, such as bariatric surgery, hyperemesis gravidarum, chronic gastrointestinal disease, HIV/AIDS, and certain malignancies, may also lead to this outcome. We are discussing one such case, WE, in a young man with acute myeloid leukemia (AML) who underwent chemotherapy. The patient presented with blurred vision, paresthesia, weakness, and vomiting. Although he denied alcohol abuse, his symptoms, physical exam findings, and MRI results were consistent with WE. Treatment with thiamine resulted in a significant improvement in his visual disturbances and mental status. The authors highlight the importance of recognizing WE in non-alcoholic patients, particularly those undergoing prolonged hospitalization and chemotherapy, as nutritional deficiencies can develop. They recommend thiamine supplementation for patients receiving chemotherapy and those with poor oral intake. The case underscores the need for high clinical suspicion and early intervention in atypical cases of WE.