AJNN

Academic Journal of Neuropsychiatry and Psychology (formerly known as the Academic Journal of Neurology and Neurosurgery, e-ISSN:3023-6517), deals with neurology, neurosurgery, psychiatry and clinical psychology accepts articles on these topics. Academic Journal of Neuropsychiatry and Psychology publishes original research articles, review articles, case reports, editorial commentaries, letters to the editor, educational articles, and conference/meeting announcements.

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Case Report
A case of Wernicke’s encephalopathy in a patient receiving teprotumumab infusions for thyroid eye disease
A 64-year-old male with clinically active thyroid eye disease was started on teprotumumab infusion for ongoing visual symptoms in the setting of managed systemic disease. After six weeks of treatment, and 3 infusions of teprotumumab, the patient developed unexplained symptoms of anxiety, confusion, and abnormal behavior over the course of several days, for which he was hospitalized. An extensive workup was unrevealing of a cause for the onset of these symptoms, and the patient did not improve until treated with supplemental thiamine, supporting a clinical diagnosis of Wernicke’s Encephalopathy. The authors will describe the circumstances of this episode and briefly summarize the available literature on encephalopathies as a serious complication in patients receiving a relatively novel treatment for thyroid eye disease.


1. Couch SM. Teprotumumab (Tepezza) for thyroid eye disease. Mo Med. 2022;119(1):36-41.
2. Kahaly GJ, Douglas RS, Holt RJ, Sile S, Smith TJ. Teprotumumab for patients with active thyroid eye disease: a pooled data analysis, subgroup analyses, and off-treatment follow-up results from two randomised, double-masked, placebo-controlled, multicentre trials.Lancet Diabetes Endocrinol. 2021;9(6):360-372. doi:10.1016/S2213-8587(21)00056-5
3. Terrarosa AK, DeMaria LN, North VS, Garcia MD, Kim ET, Belinsky I. Menstrual irregularities and amenorrhea in thyroid eye disease patients treated with teprotumumab.Ophthalmic Plast Reconstr Surg. 2024;40(3):312-315. doi:10.1097/IOP.0000000000002569
4. Belinsky I, Creighton FX Jr, Mahoney N, et al. Teprotumumab and hearing loss: case series and proposal for audiologic monitoring. Ophthal Plast Reconstr Surg. 2022;38(1):73-78. doi:10.1097/IOP. 0000000000001995
5. Galvin R, Brathen G, Ivashynka A, et al. EFNS guidelines for diagnosis, therapy and prevention of Wernicke’s encephalopathy. Eur J Neurol. 2010;17(12):1408-1418. doi:10.1111/j.1468-1331.2010.03153.x
6. Bonucchi J, Hassan I, Policeni B, Kaboli P. Thyrotoxicosis-associated Wernicke’s encephalopathy. J Gen Intern Med. 2008;23(1):106-109. doi: 10.1007/s11606-007-0438-3
7. Caine D, Halliday GM, Kril JJ, Harper CG. Operational criteria for the classification of chronic alcoholics: identification of Wernicke’s encephalopathy. J Neurol Neurosurg Psychiatry. 1997;62(1):51-60. doi: 10.1136/jnnp.62.1.51
8. Ono K, Hayano S, Kashima M. Wernicke encephalopathy: limitations in a laboratory and radiological diagnosis. BMJ Case Rep. 2023;16(12): e254786. doi:10.1136/bcr-2023-254786
9. Hoang TD, Nguyen NT, Chou E, Shakir MK. Rapidly progressive cognitive decline associated with teprotumumab in thyroid eye disease. BMJ Case Rep. 2021;14(5):e242153. doi:10.1136/bcr-2021-242153
10. Yee MD, McCarthy J, Quinn B, Surani A. Teprotumumab-induced encephalopathy: a rare side effect of a novel therapeutic. WMJ. 2023; 122(2):134-137.
Volume 2, Issue 4, 2025
Page : 86-88
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