Surges Rainer, Beck Sandra, Niesen Wolf-Dirk, Weiller Cornelius, Rijntjes Michel
Department of Neurology, University of Freiburg, Breisacherstr, 64, 79106 Freiburg, Germany.
J Neurol Sci. 2007 Sep 15;260(1-2):261-4. doi: 10.1016/j.jns.2007.04.005. Epub 2007 May 18.
We report on a patient suffering from bilateral sudden blindness as initial symptom of Wernicke's encephalopathy (WE). A 37-year-old male alcoholic was admitted to a psychiatric clinic because of excessive alcohol consumption (3.4 per thousand). 24 h later he developed acute bilateral blindness with no light perception, downbeat nystagmus, bilateral ocular abduction deficits, cerebellar ataxia as well as a slight psychomotor slowing and mild disorientation. MRI including diffusion-weighted imaging and MR-angiography 3 h after symptom onset did not reveal findings suggestive for ischemic stroke. Immediate iv-application of thiamine led to a nearly complete remission of the neuroophthalmologic symptoms within 12 h. Although we critically discuss other potential etiologies, we conclude that the complex clinical picture with initial sudden blindness is an unusual presentation of WE.
我们报告了一例以双侧突然失明为韦尼克脑病（WE）初始症状的患者。一名37岁的男性酗酒者因饮酒过量（千分之3.4）入住一家精神科诊所。24小时后，他出现急性双侧失明，无光感，下跳性眼球震颤，双侧眼球外展障碍，小脑共济失调以及轻微的精神运动迟缓与轻度定向障碍。症状出现3小时后进行的包括弥散加权成像和磁共振血管造影的MRI检查未发现提示缺血性卒中的表现。立即静脉注射硫胺素导致神经眼科症状在12小时内几乎完全缓解。尽管我们批判性地讨论了其他潜在病因，但我们得出结论，以初始突然失明为特征的复杂临床表现是WE的一种不寻常表现。
