Wernicke’s encephalopaty
atypical initial clinical manifestation
DOI:
https://doi.org/10.34024/rnc.2009.v17.8535Keywords:
Eye, Alcoholism, ParalysisAbstract
Objectives. To describe a rare case of Wernickes’s encephalopaty with bilateral complete ophthalmology and peripheral right face paralysis. Method. The Wernicke’s encephalopaty is an illness caused by thiamine deficit, generally associated with alcoholism, and is characterized by a triad of ataxia, ophthalmology, and mental confusion. Results. Patient relating that he has difficulty to open the eyes for 5 days, horizontal diplopia, and gait incoordination. Because he had ataxia, complete ophthalmology, and mental confusion, preceded for alcoholic beverage abuse, he was previously alcoholic, with injury in brain stem in magnetic resonance (hiposignal in T1 and hipersignal in T2, suggesting desmielinization) we suggested the hypothesis of Wernickes’s encephalopaty. Conclusions. The Wernicke’s encephalopaty described in 1881 by Carl Wernicke, is constituted by the classic triad of ophthalmology, ataxia, and mental confusion with acute or sub acute beginning, occurring isolated or with more frequency in association. The bilateral complete ophthalmology and the face paralysis are rare clinical manifestations of this pathology, being described in few cases in literature.
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