Recurrent Wernicke s Encephalopathy in a 16-Year-Old Girl with Atypical Clinical and Radiological Features
Background. Wernicke’s Encephalopathy (WE) is a clinical diagnosis with serious neurological consequences. Its occurrence is underestimated in nonalcoholics and is uncommon in adolescents. We aim to draw the attention to a rare case, which had additional clinical and radiological features. Case. A 1...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2014/582482 |
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| author | S. Lamdhade A. Almulla R. Alroughani |
| author_facet | S. Lamdhade A. Almulla R. Alroughani |
| author_sort | S. Lamdhade |
| collection | DOAJ |
| description | Background. Wernicke’s Encephalopathy (WE) is a clinical diagnosis with serious neurological consequences. Its occurrence is underestimated in nonalcoholics and is uncommon in adolescents. We aim to draw the attention to a rare case, which had additional clinical and radiological features. Case. A 16-year-old girl presented with three-week history of vomiting secondary to intestinal obstruction. She developed diplopia soon after hospitalization. Neurological evaluation revealed restriction of bilateral lateral recti with horizontal nystagmus, and bilateral limb dysmetria. Brain MRI was normal. She had prompt improvement to thiamine. Four months later, she presented with headache, bilateral severe deafness, and tinnitus. Clinically, she had severe sensorineural hearing loss, bilateral lateral recti paresis, and gait ataxia. CT head showed bilateral caudate nucleus hypodensities. MRI brain revealed gadolinium enhancement of mamillary bodies and vermis. She had significant improvement after IV thiamine. Headache completely resolved while the ocular movements, hearing, and tinnitus improved partially in 72 hours. Conclusions. Recurrent WE in adolescence is uncommon. Headache, tinnitus, and deafness are rare clinical features. Although MRI study shows typical features of WE, the presence of bilateral caudate nuclei hypodensities on CT scan is uncommon. Prompt treatment with thiamine is warranted in suspected cases to prevent permanent neurological sequelae. |
| format | Article |
| id | doaj-art-28e3fc22722f4c6487aabef9ed12e23a |
| institution | Kabale University |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-28e3fc22722f4c6487aabef9ed12e23a2025-08-20T03:54:47ZengWileyCase Reports in Neurological Medicine2090-66682090-66762014-01-01201410.1155/2014/582482582482Recurrent Wernicke s Encephalopathy in a 16-Year-Old Girl with Atypical Clinical and Radiological FeaturesS. Lamdhade0A. Almulla1R. Alroughani2Division of Neurology, Department of Medicine, Amiri Hospital, Arabian Gulf Street, Kuwait City, KuwaitDivision of Neurology, Department of Medicine, Amiri Hospital, Arabian Gulf Street, Kuwait City, KuwaitDivision of Neurology, Department of Medicine, Amiri Hospital, Arabian Gulf Street, Kuwait City, KuwaitBackground. Wernicke’s Encephalopathy (WE) is a clinical diagnosis with serious neurological consequences. Its occurrence is underestimated in nonalcoholics and is uncommon in adolescents. We aim to draw the attention to a rare case, which had additional clinical and radiological features. Case. A 16-year-old girl presented with three-week history of vomiting secondary to intestinal obstruction. She developed diplopia soon after hospitalization. Neurological evaluation revealed restriction of bilateral lateral recti with horizontal nystagmus, and bilateral limb dysmetria. Brain MRI was normal. She had prompt improvement to thiamine. Four months later, she presented with headache, bilateral severe deafness, and tinnitus. Clinically, she had severe sensorineural hearing loss, bilateral lateral recti paresis, and gait ataxia. CT head showed bilateral caudate nucleus hypodensities. MRI brain revealed gadolinium enhancement of mamillary bodies and vermis. She had significant improvement after IV thiamine. Headache completely resolved while the ocular movements, hearing, and tinnitus improved partially in 72 hours. Conclusions. Recurrent WE in adolescence is uncommon. Headache, tinnitus, and deafness are rare clinical features. Although MRI study shows typical features of WE, the presence of bilateral caudate nuclei hypodensities on CT scan is uncommon. Prompt treatment with thiamine is warranted in suspected cases to prevent permanent neurological sequelae.http://dx.doi.org/10.1155/2014/582482 |
| spellingShingle | S. Lamdhade A. Almulla R. Alroughani Recurrent Wernicke s Encephalopathy in a 16-Year-Old Girl with Atypical Clinical and Radiological Features Case Reports in Neurological Medicine |
| title | Recurrent Wernicke s Encephalopathy in a 16-Year-Old Girl with Atypical Clinical and Radiological Features |
| title_full | Recurrent Wernicke s Encephalopathy in a 16-Year-Old Girl with Atypical Clinical and Radiological Features |
| title_fullStr | Recurrent Wernicke s Encephalopathy in a 16-Year-Old Girl with Atypical Clinical and Radiological Features |
| title_full_unstemmed | Recurrent Wernicke s Encephalopathy in a 16-Year-Old Girl with Atypical Clinical and Radiological Features |
| title_short | Recurrent Wernicke s Encephalopathy in a 16-Year-Old Girl with Atypical Clinical and Radiological Features |
| title_sort | recurrent wernicke s encephalopathy in a 16 year old girl with atypical clinical and radiological features |
| url | http://dx.doi.org/10.1155/2014/582482 |
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