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Thiamine Deficiency With Mashed Potatoes: A Novel Case of Wernicke Encephalopathy Manifesting With Retinal Hemorrhages in a Pediatric Patient

We present a case report of a 17-year-old obese female with one-week onset of progressive confusion and double vision, associated with 50-pound weight loss in five months. On fundus examination, retinal hemorrhages and abnormalities of eye movements were seen. MRI showed abnormalities that were cons...

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Detalles Bibliográficos
Autores principales: Tiwana, Harmanpreet K, Raymond, Gerald, Littleton, Kevin, Singhal, Rishi, Kumar, Ashutosh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7553792/
https://www.ncbi.nlm.nih.gov/pubmed/33062542
http://dx.doi.org/10.7759/cureus.10429
Descripción
Sumario:We present a case report of a 17-year-old obese female with one-week onset of progressive confusion and double vision, associated with 50-pound weight loss in five months. On fundus examination, retinal hemorrhages and abnormalities of eye movements were seen. MRI showed abnormalities that were consistent with diagnosis of Wernicke encephalopathy (WE). Thiamine replacement caused gradual improvement in patient’s symptoms. Peripapillary hemorrhages on fundus examination, as seen in our patient, have been rarely seen in WE. Obesity with retinal hemorrhages, diplopia, etc. can be misleading due to idiopathic intracranial hypertension being the most common presentation in this subset. Thus, fundoscopy should be part of routine examination in WE-suspected patients.