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Wernicke’s encephalopathy in advanced cancer
  1. Samantha Brown and
  2. Suzanne Hutt-Williams
  1. Palliative Medicine, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
  1. Correspondence to Dr Samantha Brown, Macmillan Unit (NHS Hospice), University Hospitals Dorset NHS Foundation Trust, Christchurch, BH23 2JX, UK; samantha.brown{at}


This 54-year-old woman with metastatic breast cancer presented with severe confusion, incontinence and self-neglect. MRI suggested Wernicke’s encephalopathy (WE) without any history of alcohol misuse. The patient’s symptoms seemed to not respond to acute treatment. Cancer progression was assumed to be causing her condition and she was discharged to a nursing home with community palliative care team follow-up. This case demonstrates the natural course of cancer-associated WE and eventual improvement with thiamine therapy. It also illustrates a role for specialist palliative care follow up for patients discharged to a nursing home for expected end-of-life care.

  • Cancer
  • Clinical assessment
  • Neurological conditions
  • Prognosis

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  • Contributors SB conducted the literature review and drafted the original manuscript. SH-W reviewed and contributed to the manuscript and obtained informed consent for publication from the patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.