Cargando…
Imaging-Based Diagnosis of Wernicke Encephalopathy: A Case Report
INTRODUCTION: Wernicke encephalopathy (WE) is a medical emergency characterized by ataxia, confusion, nystagmus and ophthalmoplegia resulting from thiamin deficiency. Alcoholism is the common cause for this disease. CASE PRESENTATION: A 41 year old man was brought to our emergency department (ED) co...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Kowsar
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310158/ https://www.ncbi.nlm.nih.gov/pubmed/25717447 http://dx.doi.org/10.5812/traumamon.17403 |
_version_ | 1782354819052208128 |
---|---|
author | Delavar Kasmaei, Hosein Baratloo, Alireza Soleymani, Maryam Nasiri, Zahra |
author_facet | Delavar Kasmaei, Hosein Baratloo, Alireza Soleymani, Maryam Nasiri, Zahra |
author_sort | Delavar Kasmaei, Hosein |
collection | PubMed |
description | INTRODUCTION: Wernicke encephalopathy (WE) is a medical emergency characterized by ataxia, confusion, nystagmus and ophthalmoplegia resulting from thiamin deficiency. Alcoholism is the common cause for this disease. CASE PRESENTATION: A 41 year old man was brought to our emergency department (ED) complaining of confusion. One week earlier he had started to experience severe nausea and vomiting followed by diplopia, dysarthria and also dysphagia. One day later he had experienced gait disturbance and progressive ataxia accompanied with confusion, apathy and disorientation. He had no history of alcoholism, drug abuse or previous surgery but had history of untreated Crohn disease. Just before arrival to our emergency department, he had been hospitalized in another center for about a week but all investigations had failed to provide a conclusive diagnosis. Upon admission to our ED, he was dysarthric and replied with inappropriate answers. On physical examination, bilateral horizontal nystagmus in lateral gaze, left abducens nerve palsy and upward gaze palsy were seen. Gag reflex was absent and plantar reflexes were upwards bilaterally. After reviewing all the previously performed management measures, MRI was performed and was consistent with the diagnosis of WE. Treatment with thiamine led to partial resolution of his upward gaze palsy and nystagmus on the first day. At the end of the third day of treatment, except for gate ataxia, all other symptoms completely resolved and he was fully conscious. After the fifth day his gait became normal and after one week he was discharged in good general condition. DISCUSSION: After reviewing the current literature, it seems that brain MRI can be helpful in the diagnosis of WE in patients with the classic clinical trial in the absence of clear risk factors. |
format | Online Article Text |
id | pubmed-4310158 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Kowsar |
record_format | MEDLINE/PubMed |
spelling | pubmed-43101582015-02-25 Imaging-Based Diagnosis of Wernicke Encephalopathy: A Case Report Delavar Kasmaei, Hosein Baratloo, Alireza Soleymani, Maryam Nasiri, Zahra Trauma Mon Case Report INTRODUCTION: Wernicke encephalopathy (WE) is a medical emergency characterized by ataxia, confusion, nystagmus and ophthalmoplegia resulting from thiamin deficiency. Alcoholism is the common cause for this disease. CASE PRESENTATION: A 41 year old man was brought to our emergency department (ED) complaining of confusion. One week earlier he had started to experience severe nausea and vomiting followed by diplopia, dysarthria and also dysphagia. One day later he had experienced gait disturbance and progressive ataxia accompanied with confusion, apathy and disorientation. He had no history of alcoholism, drug abuse or previous surgery but had history of untreated Crohn disease. Just before arrival to our emergency department, he had been hospitalized in another center for about a week but all investigations had failed to provide a conclusive diagnosis. Upon admission to our ED, he was dysarthric and replied with inappropriate answers. On physical examination, bilateral horizontal nystagmus in lateral gaze, left abducens nerve palsy and upward gaze palsy were seen. Gag reflex was absent and plantar reflexes were upwards bilaterally. After reviewing all the previously performed management measures, MRI was performed and was consistent with the diagnosis of WE. Treatment with thiamine led to partial resolution of his upward gaze palsy and nystagmus on the first day. At the end of the third day of treatment, except for gate ataxia, all other symptoms completely resolved and he was fully conscious. After the fifth day his gait became normal and after one week he was discharged in good general condition. DISCUSSION: After reviewing the current literature, it seems that brain MRI can be helpful in the diagnosis of WE in patients with the classic clinical trial in the absence of clear risk factors. Kowsar 2014-09-10 2014-11 /pmc/articles/PMC4310158/ /pubmed/25717447 http://dx.doi.org/10.5812/traumamon.17403 Text en Copyright © 2014, Kowsar; Published by Kowsar. http://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited. |
spellingShingle | Case Report Delavar Kasmaei, Hosein Baratloo, Alireza Soleymani, Maryam Nasiri, Zahra Imaging-Based Diagnosis of Wernicke Encephalopathy: A Case Report |
title | Imaging-Based Diagnosis of Wernicke Encephalopathy: A Case Report |
title_full | Imaging-Based Diagnosis of Wernicke Encephalopathy: A Case Report |
title_fullStr | Imaging-Based Diagnosis of Wernicke Encephalopathy: A Case Report |
title_full_unstemmed | Imaging-Based Diagnosis of Wernicke Encephalopathy: A Case Report |
title_short | Imaging-Based Diagnosis of Wernicke Encephalopathy: A Case Report |
title_sort | imaging-based diagnosis of wernicke encephalopathy: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310158/ https://www.ncbi.nlm.nih.gov/pubmed/25717447 http://dx.doi.org/10.5812/traumamon.17403 |
work_keys_str_mv | AT delavarkasmaeihosein imagingbaseddiagnosisofwernickeencephalopathyacasereport AT baratlooalireza imagingbaseddiagnosisofwernickeencephalopathyacasereport AT soleymanimaryam imagingbaseddiagnosisofwernickeencephalopathyacasereport AT nasirizahra imagingbaseddiagnosisofwernickeencephalopathyacasereport |