Korean J Clin Neurophysiol.  2014 Jun;16(1):27-31. 10.14253/kjcn.2014.16.1.27.

A Case of Wernicke's Encephalopathy Presenting as Acute Bilateral Wrist Drop

• Kim DH
• Oh SY

• KMID: 1708888
• DOI: http://doi.org/10.14253/kjcn.2014.16.1.27

Abstract

Thiamine deficiency can cause peripheral polyneuropathy and Wernicke's encephalopathy. Wernicke's encephalopathy is characterized by ataxia, ophthalmoplegia, nystagmus, and confusion, and typically presents acute and rapidly progressive course, whereas peripheral neuropathy associated with thiamine deficiency manifests chronic and slowly progressive one. However, acute and rapidly progressive axonal polyneuropathy combined with Wernicke's encephalopathy is quite rare and unusual. Here, we describe a patient with Wernicke's encephalopathy who presented with acute bilateral axonal neuropathy.

Keyword

Wernicke's encephalopathy; Acute axonal polyneuropathy; Thiamine

MeSH Terms

Ataxia
Axons
Humans
Ophthalmoplegia
Peripheral Nervous System Diseases
Polyneuropathies
Thiamine
Thiamine Deficiency
Wernicke Encephalopathy*
Wrist*
Thiamine

Figure

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  Figure 1. Coronal fluid attenuated inversion recovery (FLAIR) MR images. These FLAIR images show signal intensity alterations of medial thalamus (white arrows, A) and periaqueductal area of the midbrain (white arrow, B) in an acute period of disease. After six weeks of treatment, follow-up FLAIR MR images (C and D) showed a normalized signal change in same area (A and B level) that affected by Wernicke's encephalopathy.

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