Subramanian Soundhar M, Mendonca Teena Mariet, K Srinivas Shreya, Rodrigues Gladys Reshma
Ophthalmology, Kasturba Medical College Mangalore, Mangalore, Karnataka, India.
Manipal Academy of Higher Education, Manipal, Karnataka, India.
BMJ Case Rep. 2024 Dec 15;17(12):e261085. doi: 10.1136/bcr-2024-261085.
Wernicke's encephalopathy, the acute phase of Wernicke-Korsakoff syndrome, is characterised as a triad of altered mental status, ocular signs and ataxia. Our patient presented with hyperemesis gravidarum, which is a rare aetiology of Wernicke's encephalopathy. The patient did not have any oculomotor abnormalities, which are more common and classically described in Wernicke's triad. The sudden visual loss in both eyes can be attributed to acute optic neuropathy. Our case highlights a unique ophthalmic presentation with retinal haemorrhages and optic disc oedema as unusual manifestations of Wernicke's encephalopathy. The dramatic and complete reversal of visual symptoms within 48 hours after starting parenteral thiamine retrospectively supports the diagnosis.
韦尼克脑病是韦尼克-科尔萨科夫综合征的急性期，其特征为精神状态改变、眼部体征和共济失调三联征。我们的患者表现为妊娠剧吐，这是韦尼克脑病的一种罕见病因。该患者没有任何动眼神经异常，而动眼神经异常在韦尼克三联征中更为常见且有经典描述。双眼突然失明可归因于急性视神经病变。我们的病例突出了一种独特的眼科表现，即视网膜出血和视盘水肿，这是韦尼克脑病的不寻常表现。开始胃肠外给予硫胺素后48小时内视觉症状戏剧性地完全逆转，这一情况回顾性地支持了诊断。
