{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:17:20Z","timestamp":1790957840783,"version":"4.1.0"},"reference-count":32,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T00:00:00Z","timestamp":1716508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background: Wernicke encephalopathy (WE) is an acute and potentially fatal neuropsychiatric disorder resulting from thiamine deficiency: its etiology and clinical presentation can be heterogeneous and arduously recognized, especially in children and adolescents. Case presentation: An 8-year-old girl arrived to the emergency room with ataxic gait, nystagmus, and mental confusion after a 10-day history of repeated severe vomiting; her recent clinical history was characterized by restricted nutrition due to a choking phobia, which caused substantial weight loss. Brain magnetic resonance imaging revealed a bilaterally increased T2 signal in the medial areas of the thalami and cerebral periaqueductal region. Diagnosis of WE based on clinical and neuroradiological findings was established and confirmed after labwork showing low serum thiamine. Following psychiatric evaluation, the patient was also diagnosed with avoidance-restrictive food intake disorder (ARFID), which required starting cognitive behavioral therapy and introducing aripiprazole. The patient displayed improvement of the radiological findings after one month and complete resolution of her neurological symptoms and signs. Conclusions: Eating disorders like ARFID might forerun acute signs of WE; this possibility should be considered even in pediatric patients, especially when atypical neurological pictures or feeding issues come out.<\/jats:p>","DOI":"10.3390\/diseases12060112","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T03:46:56Z","timestamp":1716522416000},"page":"112","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Wernicke Encephalopathy Caused by Avoidance-Restrictive Food Intake Disorder in a Child: A Case-Based Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5382-9101","authenticated-orcid":false,"given":"Ida","family":"Turrini","sequence":"first","affiliation":[{"name":"Pediatric Neurology Unit, Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clotilde","family":"Guidetti","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Unit, Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Contaldo","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Unit, Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Pulitan\u00f2","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Universit\u00e0 Cattolica Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7032-7779","authenticated-orcid":false,"given":"Donato","family":"Rigante","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica Sacro Cuore, 00168 Rome, Italy"},{"name":"Department of Life Sciences and Public Health, Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2267-8077","authenticated-orcid":false,"given":"Chiara","family":"Veredice","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Unit, Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.psc.2019.01.009","article-title":"Medical complications of anorexia nervosa and bulimia nervosa","volume":"42","author":"Gibson","year":"2019","journal-title":"Psychiatr. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.chc.2019.05.009","article-title":"Medical complications of eating disorders in youth","volume":"28","author":"Peebles","year":"2019","journal-title":"Child. Adolesc. Psychiatr. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"207","DOI":"10.3389\/fpsyt.2019.00207","article-title":"Neurological, psychiatric, and biochemical aspects of thiamine deficiency in children and adults","volume":"10","author":"Dhir","year":"2019","journal-title":"Front. 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