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Reversible "Pulvinar sign" in Wernicke's encephalopathy
Biju Gopalakrishnan1, Vv Ashraf1, Praveen Kumar1
1Malabar Institute of Medical Sciences Hospital, Calicut, Kerala, India.
Annals of Indian Academy of Neurology
|July 16, 2014
Summary
Young onset dementia can mimic fatal conditions. This case highlights a patient initially suspected of variant Creutzfeldt-Jakob disease (CJD) who was actually diagnosed with a treatable illness, emphasizing the need for thorough investigation.
Area of Science:
- Neurology
- Neurodegenerative Diseases
Background:
- Young onset dementia presents diagnostic challenges.
- Variant Creutzfeldt-Jakob disease (CJD) is a rapidly progressive, fatal neurodegenerative disorder.
- The pulvinar sign on MRI is a characteristic finding in CJD.
Observation:
- A patient presented with symptoms of psychosis and dementia.
- Brain MRI revealed a pulvinar sign, suggestive of CJD.
- The clinical presentation and imaging findings were initially typical for variant CJD.
Findings:
- Further investigations identified a treatable underlying condition, not CJD.
- The patient showed significant clinical improvement following treatment.
- The pulvinar sign on MRI reversed after successful treatment.
Implications:
- This case underscores the critical importance of considering treatable conditions even in presentations typical of fatal diseases.
- Thorough diagnostic workups are essential for young onset dementia patients.
- Misdiagnosis can be avoided by actively searching for treatable etiologies.
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