Coexistence Of Pellagra With Wernicke’s Encephalopathy In An Alcoholic Patient: Case Report And Review Of Literature

Agrata Sharma; Piyush Pathak

doi:10.69980/ajpr.v28i5.319

Authors

Agrata Sharma
Piyush Pathak

DOI:

https://doi.org/10.69980/ajpr.v28i5.319

Keywords:

Pellagra, Wernicke’s encephalopathy, Alcoholics, Multivitamin deficiency.

Abstract

We report a case of 30-year-old male chronic alcoholic presented with gait disturbance from last 1 year associated with cognitive impairment along with auditory and visual hallucinations. Intermittently had few episodes of seizures (GTCS). Despite continuous treatment he developed scaly itching skin rashes associated with photosensitivity and marked pain with heightened response to touch. He further worsened as he started hearing abnormal voices, suspiciousness and agitated behavior. Further the ataxia worsened and he also developed bilateral ophthalmoparesis. During hospital stay myoclonus was noticed which was startle in nature. Possibility of alcoholic pellagra encephalopathy (APE) along with Wernicke’s encephalopathy (WE) was kept and treatment was reviewed and adequate nicotinamide with thiamine supplementation was given. Clinical condition improved drastically in 1 week with resolving startle myoclonus along with resolved ophthalmoparesis. Ataxia resolved in the next one month.

Author Biographies

Agrata Sharma

Department of Neurology, AIIMS, Bhopal

Piyush Pathak

Department of Gastroenterology, AIIMS, Bhopal

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