Bitsch A, Seipelt M, Rustenbeck H H, Haug B, Nau R
Abteilung Neurologie, Georg-August-Universität, Göttingen.
Nervenarzt. 1998 Aug;69(8):707-11. doi: 10.1007/s001150050333.
Wernicke's encephalopathy (WE) is a consequence of vitamin B1 (thiamine) deficiency and in the majority of cases due to alcoholism. We report here the case of a 26-year-old male alcoholic who had stayed helplessly at home for 4 days until hospital admission. Clinical diagnosis was difficult due to major disturbance of consciousness. MRI showed an increase in signal intensity (T2-, FLAIR-weighted) around the third ventricle, the quadrigeminal bodies, the fornices, the mamillary bodies, the floor of the fourth ventricle and around the aqueduct. These findings were indicative of WE although of unusual extent. In this case MRI correlated well with clinical symptomatology. Therapy with thiamine was started immediately and symptoms as well as MRI findings resolved partially. The presented case illustrates the diagnostic usefulness of MRI in WE especially if the patient is of reduced consciousness and clinical investigation is limited.
韦尼克脑病（WE）是维生素B1（硫胺素）缺乏的结果，在大多数情况下是由酒精中毒引起的。我们在此报告一例26岁男性酒精中毒患者，他在家中无助地呆了4天，直到入院。由于意识严重障碍，临床诊断困难。MRI显示第三脑室、四叠体、穹窿、乳头体、第四脑室底部和导水管周围的信号强度增加（T2加权、液体衰减反转恢复序列加权）。这些发现提示为韦尼克脑病，尽管范围不寻常。在该病例中，MRI与临床症状密切相关。立即开始硫胺素治疗，症状以及MRI表现部分缓解。该病例说明了MRI在韦尼克脑病诊断中的有用性，特别是当患者意识减退且临床检查受限的情况下。
