双侧展神经麻痹作为一名难治性呕吐患者韦尼克脑病的一种表现。
Bilateral sixth nerve palsy as a manifestation of Wernicke's encephalopathy in a patient with refractory vomiting.
作者信息
Porfido Domenico, Guerriero Silvana, Giancipoli Giovanni, Vetrugno Michele, Lefons Velia, Dicuonzo Franca
机构信息
Department of Ophthalmology.
Department of Neuroradiology, University of Bari, Italy.
出版信息
Eye Brain. 2010 Jul 3;2:95-98. eCollection 2010.
PURPOSE
To report a case of Wernicke's encephalopathy in a nonalcoholic woman with secondary hypoadrenalism.
METHODS
A 58-year-old Italian woman developed Wernicke's syndrome secondary to recurrent vomiting due to secondary hypoadrenalism.
RESULTS
Recurrent vomiting and resulting malnutrition caused a depletion of the patient's body stores of thiamine and the development of mental confusion and an oculomotor deficit. On the diagnostic suspicion of encephalitis in this patient with immunosuppression due to prolonged cortisone-based therapy, she underwent magnetic resonance imaging, which showed typical bilateral abnormal lesions pathognomonic of Wernicke's encephalopathy. The patient improved after parenteral administration of vitamin B1.
CONCLUSIONS
Wernicke's encephalopathy must be regarded as a medical emergency that should be suspected in all cases presenting with a sudden deficit or lack of coordination of the ocular movements associated with ataxia and general degeneration of the mental faculties, in patients who have suffered recurrent vomiting or malnutrition for different reasons.
目的
报告一例继发于肾上腺功能减退的非酒精性女性韦尼克脑病病例。
方法
一名58岁的意大利女性因继发于肾上腺功能减退的反复呕吐而出现韦尼克综合征。
结果
反复呕吐及由此导致的营养不良使患者体内硫胺素储备耗竭，进而出现精神错乱和动眼神经功能障碍。由于长期使用皮质激素治疗导致免疫抑制，该患者被怀疑患有脑炎，遂接受磁共振成像检查，结果显示典型的双侧异常病变，这是韦尼克脑病的特征性表现。经肠胃外给予维生素B1后，患者病情好转。
结论
韦尼克脑病必须被视为一种医疗急症，对于所有因不同原因反复呕吐或营养不良而出现突发眼球运动功能缺陷或不协调、共济失调及精神功能全面衰退的患者，均应怀疑患有此病。
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