Blikparese en verwardheid

Two patients, women of 85 and 76 years, presented with horizontal ocular paresis. The first patient had a palliative ileocecal resection for adenocarcinoma with metastases and developed the ocular paresis only after intravenous glucose infusion. The second had chronic haemolytic anaemia and weight loss due to malnutrition. The two women were also confused. In both patients acute Wernicke's encephalopathy was diagnosed, caused by thiamine deficiency. The disorder could easily have been missed because of confounding clinical problems. Early treatment of Wernicke's encephalopathy (thiamine 100 mg/day intramuscularly for 3 days) is of major importance in preventing permanent neurological damage or even death