Wernicke Encephalopathy Mimicking MELAS.

Area of Science:

• Neurology
• Nutritional Neuroscience
• Mitochondrial Diseases

Background:

• Stroke-like lesions are characteristic of MELAS syndrome.
• Thiamine deficiency, common in alcoholism, has not been previously linked to stroke-like lesions.

Observation:

• A 62-year-old male with alcoholism presented with seizures and neurological deficits.
• MRI revealed a non-vascular stroke-like lesion with a lactate peak, initially suspected as MELAS.
• Thiamine levels were reduced, and other causes were excluded.

Findings:

• The stroke-like lesion was attributed to thiamine deficiency.
• Cerebrospinal fluid lactic acidosis was present.
• Vitamin B1 substitution led to significant recovery of cognitive and behavioral functions.

Implications:

• Thiamine deficiency may cause mitochondrial dysfunction leading to stroke-like lesions.
• Nutritional deficits should be considered in the differential diagnosis of stroke-like lesions.
• Further research is needed to explore the link between thiamine deficiency and secondary stroke-like lesions.