Wang Qiang, Charmchi Zeinab, George Ilena C
Department of Neurology, Kings County Hospital Center, SUNY Downstate Medical Center and Maimonides Medical Center, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
Department of Neurology, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.
BMC Gastroenterol. 2021 Apr 20;21(1):179. doi: 10.1186/s12876-021-01758-w.
We present a case of a woman with a past medical history of irritable bowel syndrome (IBS) and anxiety, who presents with ophthalmoplegia, ataxia and memory loss, characteristic of Wernicke encephalopathy.
A 64-year-old woman presented with double vision, unsteady gait and memory loss. These symptoms began after 3 months on an unfortified restricted diet, which she initiated to alleviate IBS symptoms. Magnetic resonance imaging of the brain demonstrated hyperintense T2-weighted signal in the dorsomedial aspect of bilateral thalami, periaqueductal grey matter and around the third ventricle. The patient's visual symptoms improved significantly after thiamine supplementation, although her memory deficits persisted.
Although WE is often associated with chronic alcohol abuse, this case demonstrates the importance of recognizing WE in any patient with a restricted diet and subsequent timely initiation of thiamine.
我们报告一例既往有肠易激综合征（IBS）和焦虑病史的女性，出现了韦尼克脑病典型的眼肌麻痹、共济失调和记忆丧失症状。
一名64岁女性出现复视、步态不稳和记忆丧失。这些症状在她开始采用未强化的限制性饮食3个月后出现，她开始这种饮食是为了缓解肠易激综合征的症状。脑部磁共振成像显示双侧丘脑背内侧、导水管周围灰质和第三脑室周围T2加权像呈高信号。补充硫胺素后，患者的视觉症状明显改善，但其记忆缺陷仍然存在。
虽然韦尼克脑病通常与长期酗酒有关，但该病例表明，认识到任何采用限制性饮食的患者中存在韦尼克脑病并及时补充硫胺素非常重要。
