Clinical Significance of Mammillary Body Enhancement in Wernicke Encephalopathy: Report of 2 Cases and Review of the Literature

Konno, Yasuhiko; Kanoto, Masafumi; Hosoya, Takamitsu; Toyoguchi, Yuki; Kawanami, Toru; Kato, Takeshi

doi:10.2463/mrms.2013-0073

Cited by 8 publications

(7 citation statements)

References 10 publications

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“…Similarly, nutrition, environment, and genetic diseases (such as Leigh syndrome) potentially overlapping with the TD spectrum might also contribute to these differences 188,189,197 . MRI protocols, such as contrast enhancement, might increase the sensitivity for mammillary bodies detection and has not been used systematically in some studies 20,23,198–201 …”

Section: Discussionmentioning

confidence: 99%

“…188,189,197 MRI protocols, such as contrast enhancement, might increase the sensitivity for mammillary bodies detection and has not been used systematically in some studies. 20,23,[198][199][200][201] Neurological presentations, such as WE in adolescents, seem more frequent in HICs than in LMICs, but this may be biased as neuroimaging is the standard of care in HICs and has contributed significantly to its diagnosis.…”

Section: To What Extent Can Higher Diagnostic Capacities In Hics Infl...mentioning

confidence: 99%

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Pediatric thiamine deficiency disorders in high‐income countries between 2000 and 2020: a clinical reappraisal

Rakotoambinina

Hiffler²,

Gomes

2021

Annals of the New York Academy of Sciences

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Often thought to be a nutritional issue limited to low-and middle-income countries (LMICs), pediatric thiamine deficiency (PTD) is perceived as being eradicated or anecdotal in high-income countries (HICs). In HICs, classic beriberi cases in breastfed infants by thiamine-deficient mothers living in disadvantaged socioeconomic conditions are thought to be rare. This study aims to assess PTD in HICs in the 21st century. Literature searches were conducted to identify case reports of PTD observed in HICs and published between 2000 and 2020. The analyzed variables were age, country, underlying conditions, clinical manifestations of PTD, and response to thiamine supplementation. One hundred and ten articles were identified, totaling 389 PTD cases that were classified into four age groups: neonates, infants, children, and adolescents. Eleven categories of PTD-predisposing factors were identified, including genetic causes, lifestyle (diabetes, obesity, and excessive consumption of sweetened beverages), eating disorders, cancer, gastrointestinal disorders/surgeries, critical illness, and artificial nutrition. TD-associated hyperlactatemia and Wernicke encephalopathy were the most frequent clinical manifestations. The circumstances surrounding PTD in HICs differ from classic PTD observed in LMICs and this study delineates its mutiple predisposing factors. Further studies are required to estimate its magnitude. Awareness is of utmost importance in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: To What Extent Can Higher Diagnostic Capacities In Hics Infl...mentioning

confidence: 99%

Pediatric thiamine deficiency disorders in high‐income countries between 2000 and 2020: a clinical reappraisal

Rakotoambinina

Hiffler²,

Gomes

2021

Annals of the New York Academy of Sciences

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“…Typical findings include bilateral and symmetrical signal hyperintensity in the thalamus, mammillary bodies, tectal plate, and periaqueductal area on T2-weighted and FLAIR sequences. 3 Changes in the mammillary bodies may be the only findings, and are present in up to 40% of cases. All three cases reported herein had mammillary body changes.…”

Section: Discussionmentioning

confidence: 99%

“…Untreated WE may progress to the Korsakoff syndrome, an irreversible disorder characterized by anterograde and retrograde amnesia. 3…”

Section: Introductionmentioning

confidence: 99%

Wernicke’s encephalopathy mimicking neuropsychiatric symptoms in patients with systemic lupus erythematosus: a report of three cases and literature review

Appenzeller

Reis

Costallat

et al. 2016

Lupus

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Systemic lupus erythematosus (SLE) is a chronic inflammatory disease that involves many organs and systems. Nervous system involvement in SLE encompasses neurological and psychiatric disorders, and remains a diagnostic and therapeutic challenge. Wernicke's encephalopathy (WE) is a neurological disorder that occurs as a consequence of thiamine deficiency, and its clinical presentation resembles the neuropsychiatric events attributed to SLE (NPSLE). Differentiation between these two entities is crucial because their treatment differs greatly and can change prognosis. We describe three cases of patients with SLE who presented with initial clinical findings suggestive of NPSLE that, at the end of a thorough clinical investigation, were actually found to represent WE. In all of these cases, treatment with thiamine resulted in significant improvement. WE should be considered as a differential diagnosis in SLE patients with neuropsychiatric signs and symptoms, especially when risk factors for thiamine deficiency are present.

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“…Y. Konno и соавт. [18] отметили, что патологическое накопление контраста в области маммилярных тел, которое может обнаруживаться при отсутствии изменения сигнала в МРТ режимах Т2-ВИ и FLAIR, является патогномоничным признаком СВК.…”

Section: Discussionunclassified

Wernicke–Korsakoff syndrome

Sv¹,

Ai²,

Ev³

et al. 2016

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Clinical Significance of Mammillary Body Enhancement in Wernicke Encephalopathy: Report of 2 Cases and Review of the Literature

Cited by 8 publications

References 10 publications

Pediatric thiamine deficiency disorders in high‐income countries between 2000 and 2020: a clinical reappraisal

Pediatric thiamine deficiency disorders in high‐income countries between 2000 and 2020: a clinical reappraisal

Wernicke’s encephalopathy mimicking neuropsychiatric symptoms in patients with systemic lupus erythematosus: a report of three cases and literature review

Wernicke–Korsakoff syndrome

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