Wernicke Encephalopathy Presenting With Hearing Loss and Vision Loss in a Nonalcoholic Patient

Wernicke encephalopathy is an acute neuropsychiatry syndrome resulting from thiamine deficiency associated with significant morbidity and mortality. We reported a case of a 25-year-old woman with a history of abdomen pain, nausea, vomiting, weight loss, and sore throat who presented with acute neurological symptoms, including binocular diplopia, hearing loss, vision loss, and difficulty ambulating. Examination revealed bilateral vision loss with perception only to light, ophthalmoplegia, hearing loss, gait ataxia, and areflexia. Laboratory work detected multiple vitamin deficiencies. Magnetic resonance imaging (MRI) of the brain showed increased T2 signal in the bilateral medial thalami and periaqueductal areas. Empirical treatment with intravenous thiamine resulted in rapid clinical and radiological resolution.