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Wernicke encephalopathy presenting as a stroke mimic: A case report
Ermir Roçi1, Emili Mara2, Stela Dodaj2
1Stroke Unit, Service of Neurology, University Hospital Center Mother Theresa, Tirana 1005, Albania.
World Journal of Clinical Cases
|July 7, 2025
Summary
Wernicke encephalopathy (WE) can mimic stroke symptoms, posing a diagnostic challenge. Early recognition and thiamine treatment are crucial for better outcomes in patients with risk factors.
Area of Science:
- Neurology
- Internal Medicine
Background:
- Wernicke encephalopathy (WE) is a neurological disorder caused by thiamine deficiency.
- WE can present with acute neurological symptoms, mimicking stroke.
- Risk factors include alcoholism, malnutrition, hyperemesis gravidarum, and bariatric surgery.
Observation:
- A 63-year-old man presented with acute neurological deficits including left-sided weakness, dizziness, and confusion.
- Initial evaluation suggested a transient ischemic attack, but stroke imaging was unremarkable.
- The patient had a history of chronic alcohol abuse and abnormal liver function tests.
Findings:
- Magnetic resonance imaging revealed abnormalities in the subthalamic areas.
- Electroencephalogram showed diffuse delta activity.
- These findings, along with clinical presentation and history, supported a diagnosis of WE.
Implications:
- WE should be considered in the differential diagnosis of stroke-like presentations, especially with risk factors.
- Prompt recognition and treatment with intravenous thiamine are critical.
- Delayed diagnosis and treatment can lead to adverse outcomes.
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