Epileptic seizures as the first symptom of Wernicke's encephalopathy with cerebral cortical lesions. (June 2017)

• Record Type: Journal Article
• Authors: Fu, Kailei; Tian, Li; Xue, Weishuang; Teng, Weiyu
• Is Part Of: Journal of clinical neuroscience. Volume 40(2017:Jun.)
• Page Start: 50
• Page End: 52
• Publication Date: 2017-06
• Subjects: Wernicke's encephalopathy -- Cerebral cortex -- Epileptic seizures -- Prognosis; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2017.01.016
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Epileptic seizures is a rare clinical manifestation in the Wernicke's encephalopathy with cerebral cortical lesions (WEc). Magnetic resonance imaging finding in the cortex of our patient is typical and impressive. We speculate the possible mechanisms of Epileptic seizures in the WEc. Abstract: Wernicke's encephalopathy (WE) is acute metabolic disease of the central nervous system caused by deficiency of thiamine. Typical imaging findings are bilateral and symmetric signal in mammillary bodies, medial thalamus and periaqueductal gray. We present a 45-year-old man diagnosed for WE with two seizures and unconsciousness. The magnetic resonance imaging showed bilateral and symmetrical signal hyper-intensities in the frontal and parietal cortex, in addition to the classical MRI findings of WE. Cortical damage in WE is rare. The patient was improved significantly from unconsciousness to obeying commands and answering questions after 3 days by thiamine supplementation. But the muscle strength and conscious state did not improve after 1 year. This case report reminds us that we should take into account the possibility of WE when imaging shows cortical damage.