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Wernicke Encephalopathy
Arch Neurol. 2004;61:775-776.
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A 50-year-old woman was admitted to the hospital with dyspnea and pancytopenia after autologous stem cell transplantation for multiple myeloma. Her hospitalization was complicated by poor oral intake and nausea and vomiting from a previously diagnosed villous adenoma with gastrointestinal bleeding. Over 2 weeks, she became lethargic, inattentive, and disoriented. She could not count fingers at 1 foot, had pale optic discs, poor abduction of the left eye, horizontal end-gaze nystagmus, and postural tremor. She could not register 3 words at 10 seconds. One day after receiving intravenous thiamine, she was alert, attentive, registered 3 words, had full extraocular movements, and visual acuity of 20/50 OD and 20/40 OS. Within 72 hours, she was oriented to person and place but was unable to recall 3 words at 1 minute. Magnetic resonance imaging of the brain showed increased signal in the optic chiasm and mamillary bodies on fluid-attenuated inversion recovery images . . . [Full Text of this Article]
Zeyad Morcos, MD;
Samuel C. Kerns
Cleveland, Ohio
Barbara E. Shapiro, MD, PhD
Associate Professor of Neurology
University Hospitals of Cleveland
Case Western Reserve University School of Medicine
11100 Euclid Ave, Bolwell 2700
Cleveland, OH 44106-5098
(e-mail: bes002@aol.com)
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