Annals of Rehabilitation Medicine  2017;41(1):158-161

doi:10.5535/arm.2017.41.1.158

Hypothermia Presenting in Wernicke Encephalopathy: A Case Report.

Seok Hyun HONG 1 ; Ju Sun OH ; Chang Hyun LEE ; Jae Ho OH

Affiliations

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Keywords

Hypothermia; Wernicke encephalopathy

Country

Republic of Korea

Language

English

Abstract

Wernicke encephalopathy (WE) is a neurologic disorder characterized by clinical symptoms, such as nystagmus, ataxia, and mental confusion. Hypothermia in patients with WE is a rare complication, and its pathogenic mechanism and therapy are yet to be ascertained. Herein, we presented a case of a 61-year-old man who was diagnosed with WE 3 months earlier. We investigated the cause of hypothermia (35.0℃) that occurred after an enema (bowel emptying). Brain magnetic resonance imaging revealed mammillary body and hypothalamus atrophy. In the autonomic function test, the sympathetic skin response (SSR) test did not evoke SSR latencies on both hands. In addition, abnormal orthostatic hypotension was observed. Laxative and stool softener medication were administered, and his diet was modified, which led to an improvement in constipation after 2 weeks. Moreover, there was no recurrence of hypothermic episode. This is the first reported case of late-onset hypothermia secondary to WE.