Department of Gastroenterology, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, 710018, People's Republic of China.
Department of Radiology, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, 710018, People's Republic of China.
BMC Neurol. 2023 Jul 31;23(1):285. doi: 10.1186/s12883-023-03337-w.
Wernicke encephalopathy (WE) is a devastating acute or subacute neurological disorder caused by thiamine deficiency. Wernicke encephalopathy is characterized by the triad of ocular signs, cerebellar dysfunction, and confusion. Visual loss and hearing loss are less common findings in WE. Here, we report a case of Wernicke encephalopathy in a nonalcoholic liver cirrhosis patient who presented with acute bilateral deafness and bilateral blindness. CASE PRESENTATION: A 60-year-old Chinese man presented with a history of bilateral blindness and bilateral hypoacousia for 3 days. He had a history of liver cirrhosis and chronic hepatitis C virus infection and did not have a habit of alcohol consumption. Ophthalmologic and otologic examinations showed no obvious abnormalities. MRI findings revealed symmetric fluid-attenuated inversion recovery (FLAIR) hyperintensities in the bilateral medial dorsal thalamus, periventricular region around the third ventricle and tectum, and dorsal medulla oblongata. One day after hospitalization, the patient developed a mild coma. Based on the laboratory and neuroimaging findings, we diagnosed the patient with Wernicke encephalopathy. He soon regained consciousness after administration of thiamine. Both his visual acuity and his hearing function improved gradually.
We suggest that Wernicke encephalopathy can present with bilateral blindness and bilateral deafness.
Wernicke 脑病（WE）是一种由硫胺素缺乏引起的破坏性急性或亚急性神经障碍。Wernicke 脑病的特征是眼征、小脑功能障碍和意识混乱三联征。WE 中视力和听力丧失的发现较少见。在这里，我们报告了一例非酒精性肝硬化患者的 Wernicke 脑病，该患者表现为急性双侧耳聋和双侧失明。
一名 60 岁的中国男性，因双侧失明和双侧听力下降 3 天就诊。他有肝硬化和慢性丙型肝炎病毒感染病史，没有饮酒习惯。眼科和耳科检查未见明显异常。MRI 结果显示双侧内侧背丘脑、第三脑室周围室周区和顶盖、背侧延髓存在对称的液体衰减反转恢复（FLAIR）高信号。住院 1 天后，患者出现轻度昏迷。根据实验室和神经影像学检查结果，我们诊断该患者为 Wernicke 脑病。给予硫胺素治疗后，他很快恢复了意识。他的视力和听力功能逐渐改善。
我们建议 Wernicke 脑病可表现为双侧失明和双侧耳聋。
