韦尼克脑病：超越酒精中毒
Wernicke's encephalopathy: beyond alcoholism.
作者信息
Wilson Robin K, Kuncl Ralph W, Corse Andrea M
机构信息
Department of Neurology, Johns Hopkins University, Baltimore, MD 21287-7519, USA.
出版信息
Nat Clin Pract Neurol. 2006 Jan;2(1):54-8; quiz 58. doi: 10.1038/ncpneuro0094.
BACKGROUND
A 17-year-old pregnant woman presented to hospital at 19 weeks' gestation with an 8-week history of hyperemesis gravidarum, 16.8 kg of weight loss, and new-onset weakness, dizziness and blurred vision. Examination of the patient showed confusion, papilledema, ophthalmoparesis, nystagmus, reduced hearing and truncal ataxia.
INVESTIGATIONS
Physical examination, abdominal ultrasound, fetal ultrasound, brain MRI, magnetic resonance angiography, magnetic resonance venography and cerebrospinal-fluid analysis.
DIAGNOSIS
Wernicke's encephalopathy, hyperemesis gravidarum and fetal loss.
MANAGEMENT
Intravenous thiamine repletion and elimination of deficiency risk factors.
背景
一名17岁孕妇在妊娠19周时入院，有8周的妊娠剧吐病史，体重减轻16.8千克，且出现新发的乏力、头晕和视力模糊。对该患者的检查显示有精神错乱、视乳头水肿、眼球运动障碍、眼球震颤、听力减退和躯干共济失调。
检查
体格检查、腹部超声、胎儿超声、脑部磁共振成像、磁共振血管造影、磁共振静脉造影和脑脊液分析。
诊断
韦尼克脑病、妊娠剧吐和胎儿丢失。
治疗
静脉补充硫胺素并消除缺乏风险因素。
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