Lindholt Michael E
Holstebro Centralsygehus, Øjenafdelingen.
Ugeskr Laeger. 2006 Apr 3;168(14):1451-2.
A 42-year-old man presented in the Department of Ophthalmology of Holstebro Central Hospital with a history of alcohol abuse, vomiting and weight loss. The initial symptoms of beriberi were stiffness of the legs and a picture of Wernicke's syndrome. He had bilateral loss of horizontal eccentric gaze holding and upbeat nystagmus, and visual acuity was reduced to counting fingers. Visual acuity was tested in the down-gaze position and increased to 0.3 because of reduced nystagmus. The patient's oculomotor function improved dramatically after treatment with thiamine. Wernicke's encephalopathy and beriberi are discussed, highlighting that nystagmus may be the single ocular symptom. It should be considered in the differential diagnosis of bilateral ophthalmoplegia even in the absence of altered mental status.
一名42岁男性因酗酒、呕吐和体重减轻的病史就诊于霍尔斯特布罗中心医院眼科。脚气病的初始症状为腿部僵硬和韦尼克综合征表现。他存在双侧水平偏心注视保持丧失和上视性眼球震颤，视力降至仅能数指。在向下注视位置测试视力时，由于眼球震颤减轻，视力提高到了0.3。患者经硫胺素治疗后动眼功能显著改善。文中讨论了韦尼克脑病和脚气病，强调眼球震颤可能是唯一的眼部症状。即使在精神状态未改变的情况下，双侧眼肌麻痹的鉴别诊断中也应考虑到这一点。
