Case of non-alcoholic Wernicke's encephalopathy
| Autor: | Saroj Meena, Michael Haley, Ausrine Zykaite, Mark D Theodoreson |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Neurology Mammillary body Vomiting Encephalopathy Neurological examination Fluid-attenuated inversion recovery Wernicke's encephalopathy 03 medical and health sciences 0302 clinical medicine Rare Disease Weight Loss medicine Diplopia Humans Wernicke Encephalopathy Obesity Thiamine Palsy medicine.diagnostic_test business.industry 030208 emergency & critical care medicine Nausea General Medicine Middle Aged medicine.disease Anesthesia Vitamin B Complex medicine.symptom business Tomography X-Ray Computed 030217 neurology & neurosurgery |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| Popis: | A 61-year-old obese man presented with 8-week history of nausea and occasional vomiting. He reported poor appetite and unintentional weight loss of more than 20 kg of his body mass. A week after admission, he developed double vision and unsteady gait. Neurological examination revealed isolated sixth cranial nerve palsy on the left side with horizontal nystagmus that progressed to bilateral lateral gaze palsy with normal vertical gaze. Brain MR revealed T2/fluid attenuation inversion recovery (FLAIR) high signal in mammillary bodies, tectum of the midbrain and the periaqueductal grey matter. He was diagnosed with Wernicke’s encephalopathy (WE). WE is a medical emergency that carries high mortality yet can be often under-diagnosed in the non-alcoholic patient. Varied presentation and absence of alcohol dependence lowers the degree of suspicion and this was true in this case. The patient was given intravenous thiamine and made a rapid and dramatic recovery. |
| Databáze: | OpenAIRE |
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