Case of Atypical Wernicke's Encephalopathy in a GB Cancer Patient.
- Author:
Yun Hwa JUNG
1
;
Hyun Ah YU
;
Gun Jung YOUN
;
Ja In LEE
;
In Sook WOO
;
Chi Wha HAN
Author Information
1. Division of Hematology-Oncology, Department of Internal Medicine, Yeouido St Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. cwhan@unitel.co.kr
- Publication Type:Case Report
- Keywords:
Wernicke's encephalopathy;
Metronidazole;
Cerebellar nuclei
- MeSH:
Ataxia;
Brain;
Cerebellar Nuclei;
Cerebellum;
Consciousness;
Edema;
Humans;
Mamillary Bodies;
Metronidazole;
Thiamine;
Thiamine Deficiency;
Wernicke Encephalopathy
- From:Korean Journal of Medicine
2013;84(4):602-607
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Wernicke's encephalopathy (WE) is an acute neuropsychiatric syndrome resulting from thiamine deficiency. Traditionally, diagnosis of WE rests on a clinical symptom triad consisting of ocular signs, altered consciousness, and ataxia. However, the complete triad is only present in a fraction of cases, which means that WE tends to be under-diagnosed, especially in nonalcoholic patients. Brain MRI of WE patients usually shows symmetrical signal intensity alterations in the thalami, mammillary bodies, and periaqueductal area, because of cytotoxic edema in the same region. These typical findings are useful diagnostic leads in WE patients with atypical symptoms. However, atypical findings can occasionally be seen in the vermis of cerebellum and cerebellar nuclei. Notably, alterations of signal intensity in the cerebellar dentate nuclei, which is a typical finding of metronidazole-induced encephalopathy (MIE), need to be distinguished according to medication history and response to thiamine.
