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Wernicke's encephalopathy with pinpoint pupils and diplopia
Hongjia Xu1, Na Shao1, Zhengyu Zhu1
1Department of Neurology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
BMC Neurology
|October 31, 2024
Summary
This case report details a rare instance of Wernicke's encephalopathy presenting with pinpoint pupils. We discuss this unusual clinical finding and explore potential underlying mechanisms for this atypical presentation.
Area of Science:
- Neurology
- Ophthalmology
- Clinical Case Studies
Background:
- Wernicke's encephalopathy (WE) is a serious neurological complication often associated with thiamine deficiency.
- Typical ocular manifestations of WE include nystagmus and ophthalmoplegia, but pupillary abnormalities are less commonly reported.
- Pinpoint pupils (miosis) are not a characteristic sign of WE, making their presence in this condition noteworthy.
Observation:
- A female patient diagnosed with Wernicke's encephalopathy exhibited pinpoint pupils (miosis).
- This pupillary finding is considered an atypical and rare clinical manifestation.
Findings:
- The case highlights the variability in clinical presentation of Wernicke's encephalopathy.
- The presence of miosis in this context challenges typical diagnostic criteria and understanding.
Implications:
- This report underscores the importance of considering diverse clinical signs in diagnosing Wernicke's encephalopathy.
- Further research is warranted to explore the specific pathophysiological mechanisms linking thiamine deficiency to miosis.
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