J Korean Med Sci.  2009 Aug;24(4):747-750. 10.3346/jkms.2009.24.4.747.

A Case of Wernicke's Encephalopathy Following Fluorouracil-based Chemotherapy

• Cho IJ
• Chang HJ
• Lee KE
• Won HS
• Choi MY
• Nam EM
• Mun YC
• Lee SN
• Seong CM

• KMID: 1779215
• DOI: http://doi.org/10.3346/jkms.2009.24.4.747

Abstract

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.

Keyword

Fluorouracil; Wernicke's Encephalopathy; Thiamine

MeSH Terms

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