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Wernicke's encephalopathy: report of a case
Verajit Chotmongkol1, Panita Limpawattana
1Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Summary
Wernicke's encephalopathy, a neurological disorder, can cause confusion and eye movement issues. Prompt treatment with intravenous thiamine (vitamin B1) can lead to significant recovery of neurological functions.
Area of Science:
- Neurology
- Neuroimaging
- Nutritional Neuroscience
Background:
- Wernicke's encephalopathy (WE) is a serious neurological complication of thiamine deficiency, often associated with chronic alcoholism.
- Early diagnosis and treatment are crucial to prevent severe, irreversible neurological damage.
Observation:
- A 53-year-old male with a history of alcoholism presented with acute confusion, left upward gaze palsy, and gait ataxia.
- Brain MRI revealed characteristic findings including signal abnormalities in the basal ganglia, thalami, midbrain, pons, and periventricular regions, alongside atrophic changes.
Findings:
- Intravenous thiamine (100 mg/day) administration resulted in complete recovery of the left upward gaze palsy within 8 days.
- Significant improvement in mental status and gait ataxia was observed following thiamine treatment.
Implications:
- This case highlights the importance of recognizing clinical and MRI findings suggestive of Wernicke's encephalopathy in at-risk individuals.
- Prompt initiation of thiamine therapy is essential for reversing acute neurological deficits and improving patient outcomes in Wernicke's encephalopathy.