Wernicke's Encephalopathy After Laparoscopic Cardiomyotomy for Achalasia

Abstract

Achalasia is an incurable neuromuscular disorder of the esophagus, resulting from destruction of the esophageal myenteric plexus. This leads to aperistalsis and failure of the lower esophageal sphincter to relax after swallowing. Symptoms of achalasia are gradual in onset and include dysphagia, regurgitation, and weight loss. Severe malnutrition can ensue. Wernicke's encephalopathy (WE) is a serious, potentially fatal, neurologic disorder caused by thiamine deficiency (vitamin B₁), classically described as presenting with a triad of ocular abnormalities, ataxia, and confusion. The incidence is uncertain, and many cases likely go unrecognized. It is usually diagnosed in the alcoholic population. We describe its onset after the successful surgical treatment of achalasia.

Wernicke’s encephalopathy is a potentially fatal, neurological disorder caused by thiamine deficiency (vitamin B₁), often causing ocular abnormalities, ataxia, and confusion. It is usually diagnosed in the alcoholic population however, we describe for the first time its onset after the successful surgical treatment of achalasia.