Pancreatic encephalopathy and Wernicke encephalopathy in association with acute pancreatitis: A clinical study

Table 1 Manifestation and outcome of patients with encephalopathy

No.	Sex	Age (yr)	Primary disease	Manifestation of encephalopathy	Diagnosis	Treatment/Outcome
1	M	29	SAP with ARDS.	4th d of onset, restlessness, haziness, delirium. Pathological sign negative.	PE	Diazepam, haloperidol. Recovery
2	F	51	SAP	At onset, haziness, delirium.	PE	Recovery
3	M	41	SAP with ALI.	4th d of onset, restlessness, sleepiness, haziness.	PE	Recovery
4	M	34	SAP with pseudocyst bleeding	SAP for 3 mo, 3rd d after pseudocyst operation, hallucination, delirium, conjugate gaze palsies, coma, suspected Kernig sign. Diffused pancreatic necroses.	PE	Death
5	F	42	SAP with ALI and shock	9th d of onset, delirium, unconsciousness.	PE	Death
6	M	31	SAP with ARF and ARDS.	33rd d after onset, restlessness, hebetude, unconsciousness, delirium.	PE	Death
7	F	37	Recovery Phase of AP	Protracted vomiting. No supplement of VitB1. 36th d after onset, diplopia, tinnitus, apathy, dizziness, horizontal nystagmus. CSF negative, MRI negative.	WE	VitB1, B12 im. Recovery after 4 d
8	M	48	Recovery Phase of SAP, with ALI and pseudocyst	45th d of onset, diplopia, sleepiness, haziness, horizontal nystagmus, spatial disorientation, decreased tendon reflex.	WE. Once suspected PE	Fasting for 51 d, no VitB1 in TPN for 44 d. Recovery after 4-day’s administration of VitB1
9	M	37	Acute recurrent pancreatitis with pseudocyst	Long fasting, no supplement of VitB1. Nausea, vomiting, dizziness, hypomnesia, alalia, diplopia, amentia, coma. Conjugate gaze palsies, active tendon reflex, ankle clonus positive. CSF: total cells 134, WBC 2; glucose, protein increased lightly. MRI: suspected focus of brain stem.	WE. Once suspected PE and encephalitis	Dexamethasone ineffective. Administration of VitB1, 400 mg/d. Death
10	F	40	Recovery phase of AP	42nd d after onset, vomiting, dizziness, alalia, trance, amentia, sleeplessness, hyperspasmia, coma. Myosis, decreased tendon reflex. Pathological signs negative. CSF: protein positive; total cells 180, WBC 0; glucose, protein increased lightly.	WE. Once suspected viral encephalitis	Dexamethasone, acyclovir ineffective. Respirator. Death

ALI: acute lung injury; ARF: acute renal failure; ARDS: acute respiratory distress syndrome; CSF: cerebrospinal fluid; TPN: total parenteral nutrition.