|LETTER TO EDITOR
|Year : 2021 | Volume
| Issue : 1 | Page : 62-63
Wernicke's encephalopathy: It not always alcohol
Bindu Menon1, Manisha Sharma1, Gayatri Manam2
1 Department of Neurology, Apollo Speciality Hospital, Nellore, Andhra Pradesh, India
2 Department of Radiology, Apollo Speciality Hospital, Nellore, Andhra Pradesh, India
|Date of Submission||25-Jul-2020|
|Date of Decision||10-Feb-2021|
|Date of Acceptance||11-Feb-2021|
|Date of Web Publication||22-Mar-2021|
Department of Neurology, Apollo Speciality Hospital, 16/111/1133, Muttukur Road, Pinakini Nagar, Nellore, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Menon B, Sharma M, Manam G. Wernicke's encephalopathy: It not always alcohol. Apollo Med 2021;18:62-3
A 16-year-old female child came to emergency with increasing sleepiness and forgetfulness of 10 days' duration. Parents reported that the patient had substantially reduced her diet and frequently skipped meals after having recently shifted to the hostel for her studies. Blood investigation was normal. Her magnetic resonance imaging (MRI) axial flair and T2-weighed images showed bilateral symmetrical hyperintensities in the mammillary bodies, periventricular region of the third ventricle, medial thalami, and periaqueductal area with corresponding diffusion-weighted imaging and apparent diffusion coefficient not showing any diffusion restriction [Figure 1]a,[Figure 1]b,[Figure 1]c,[Figure 1]d. The features were suggestive of Wernicke's encephalopathy (WE). The patient was given 500 mg thiamine followed by a maintenance dose for 2–3 days followed by oral medication. She showed dramatic improvement in her symptoms within 3 days and was asymptomatic after 3 months on follow-up with almost complete resolution of her MRI findings [Figure 2]a and [Figure 2]b.
|Figure 1: Magnetic resonance imaging axial flair (a)and T2 weighed images (b)showing bilateral symmetrical hyperintensities in the mammillary bodies, periventricular region of third ventricle, medial thalami, and periaqueductal area with corresponding diffusion weighted imaging (c)and apparent diffusion coefficient (d)not showing any diffusion restriction|
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|Figure 2: Magnetic resonance imaging T2 weighted images (a,b) showing almost complete resolution of findings|
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WE is an acute-onset neuropsychiatric disorder with the usual manifestation of the triad of symptoms of ataxia, oculomotor abnormalities, and confusional state due to Vitamin B1 deficiency. Alcohol intake is the most common etiology. However, nutritional deficiency can also produce WE. This case highlights that a high index of suspicion is needed for a favorable outcome.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the parents have given their consent for images and other clinical information to be reported in the journal. The parents understand that names and initials will not be published, and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2]