Illinois Neurologic Institute, University of Illinois College of Medicine, Peoria, USA.
J Neurol. 2018 Jan;265(1):213-215. doi: 10.1007/s00415-017-8670-1. Epub 2017 Nov 15.
Bilateral medial vestibular nuclei (MVN) is a common target in thiamine depletion and results in acute vestibular failure. Involvement of the MVN was present in 27 out of 38 brainstem sections reported in the largest thiamine deficiency autopsy cohort with Wernicke's encephalopathy.
Serial clinical, imaging and vestibulo-ocular reflex gain measured with the video head impulse (vHIT) in one patient with acute thiamine deficiency.
Low horizontal VOR gain correlated with an abnormal manual head impulse and with MRI evidence of MVN in an alcohol-dependent patient with low thiamine levels. The vertical VOR gain was either normal or mildly abnormal. Thiamine replacement and normal diet restored the VOR gain and MRI signal changes to normal.
This single case study provides clinical-imaging correlation for symmetric MVN compromise in thiamine deficiency, its effect on the VOR gain and the favorable response to thiamine and diet replacement when identified early.
双侧内侧前庭核（MVN）是硫胺素耗竭的常见靶点，导致急性前庭衰竭。在最大的伴有韦尼克脑病的硫胺素缺乏症尸检队列中报告的 38 个脑干切片中，有 27 个涉及 MVN。
对一名急性硫胺素缺乏症患者进行连续的临床、影像学和前庭眼反射增益（通过视频头脉冲试验[vHIT]测量）。
低水平的水平 VOR 增益与异常手动头脉冲以及酒精依赖患者的 MVN 的 MRI 证据相关，该患者的硫胺素水平较低。垂直 VOR 增益正常或轻度异常。硫胺素替代和正常饮食使 VOR 增益和 MRI 信号变化恢复正常。
这项单病例研究为硫胺素缺乏症中对称的 MVN 损伤提供了临床-影像相关性，以及它对 VOR 增益的影响，以及在早期发现并进行硫胺素和饮食替代治疗时的良好反应。
