PDF(Pubmed)
Abstract：
Wernicke encephalopathy (WE) is a rare but severe neurological syndrome characterized, in its classic form, by the acute onset of ocular disturbances, ataxia, and cognitive impairment. It is caused by a deficiency of thiamine (vitamin B1) and mainly affects chronic alcoholics, although it can also affect patients with pathologies that lead to malnutrition. We present a case of a 58-year-old woman, who presented with significant weight loss over the past 6 months and who came to the emergency department for episodes of repetitive vomiting and a sleepy state. The patient underwent blood chemistry tests and a brain CT scan, which revealed symmetrical and bilateral hypodensity of the medial portion of the thalamus, tectal plate, and periaqueductal gray matte, suggestive of WE. She was subsequently referred to the Department of Neurology and underwent a brain MRI, which confirmed the clinical suspicion. She also had an abdominal CT scan and ileo-colonoscopy and was diagnosed with Crohn\'s disease. Immediately after the clinical diagnosis of WE, a replacement therapy based on intravenous thiamine at high doses was promptly set up, and the patient improved from a clinical point of view. Wernicke encephalopathy can be difficult to diagnose when it occurs in non-alcoholic patients; WE associated with IBD is a rare condition, and it can present with atypical and more subtle symptoms. Radiologists and physicians must be aware of this condition and imaging findings for rapid diagnosis and treatment.
摘要：
韦尼克脑病（WE）是一种罕见但严重的神经系统综合征，以其经典形式，由于眼部疾病的急性发作，共济失调,和认知障碍。它是由硫胺素（维生素B1）缺乏引起的，主要影响慢性酗酒者，尽管它也会影响导致营养不良的病理患者。我们介绍了一个58岁女性的案例,在过去的6个月中，他们出现了明显的体重减轻，并且因反复呕吐和昏昏欲睡而来到急诊室。病人接受了血液化学测试和脑部CT扫描,显示丘脑内侧部分的对称和双侧低密度，台板,和水管周围的灰色哑光，暗示我们。随后，她被转诊到神经内科，并接受了脑部MRI检查，这证实了临床怀疑。她还进行了腹部CT扫描和回肠结肠镜检查，并被诊断患有克罗恩病。在WE的临床诊断后，迅速建立了基于高剂量静脉注射硫胺素的替代疗法，从临床角度来看，患者有所改善。当Wernicke脑病发生在非酒精性患者时，很难诊断;与IBD相关的WE是一种罕见的疾病，它可以表现出非典型和更微妙的症状。放射科医生和医生必须意识到这种情况和影像学发现，以便快速诊断和治疗。
