维尼克-科尔萨科夫脑病变的非典型表现,模仿左半球中风:病例报告
Ioana Butnariu1,2, Daniela Nicoleta Anghel2, Adela Magdalena Ciobanu1,3
1Department of Neurology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Frontiers in psychiatry
|January 6, 2025
概括
维尼克-科尔萨科夫脑病,一种维生素B1缺乏症,可以模仿脑卒中症状,如失言症和半衰竭. 及时的维生素B1治疗导致了一名表现异常的患者完全康复.
科学领域:
- 神经学 神经学
- 代谢疾病 代谢疾病
- 神经成像是一种神经成像.
背景情况:
- 维尼克-科尔萨科夫脑病变 (WERNICKE-KORSAKOFF ENCEPHALOPATHY) 是由于维生素B1缺乏而导致的严重代谢障碍,主要影响慢性酒精滥用患者.
- 临床表现通常包括精神状态的改变,记忆力缺陷,眼睛衰竭和动力衰竭.
- 这一案例凸显了急性诊断环境中的诊断挑战,特别是当WKE模仿中风并影响紧急治疗决策时.
研究的目的:
- 报告一个独特的Wernicke-Korsakoff脑病变病例,呈现出模仿左半球中风的症状.
- 突出非典型WKE在急性临床环境中所带来的诊断挑战.
- 强调在类似中风的表现的差异诊断中考虑WKE的重要性,特别是在正常的初始成像时.
主要方法:
- 一个年轻男性患者的案例研究,他有慢性酒精滥用和营养不良的病史.
- 临床评估包括神经和心理评估,复杂的困惑和失语症.
- 最初的脑电脑断层扫描 (CT) 扫描,其次是磁共振成像 (MRI) 来识别大脑病变.
- 静脉注射维生素B1的治疗和随后的临床结果评估.
主要成果:
- 患者出现了急性发病的右半和语言障碍,强烈暗示左半球中风.
- 最初的CT扫描没有什么显著的;然而,MRI显示了脑干,丘脑和双侧额叶的病变.
- 在静脉注射维生素B1后,患者在8周内缓慢但完全康复.
- 随后,该患者被转移到成治疗中心.
结论:
- 非典型的韦尼克-科尔萨科夫脑病变可能表现出与中风非常相似的症状,特别是脊柱基础性病变.
- 这个案例代表了WKE模仿左半球中风与失语和半的首次报告的例子.
- 准确和及时的诊断对于适当的管理至关重要,特别是在紧急情况下,初始成像可能是正常的,这会影响急性中风治疗的决定.
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