Rapid same-day resolution of internuclear ophthalmoplegia in Wernicke encephalopathy following parenteral high dose thiamine

Winters, Jacob; Niespodzany, Eric; Kini, T. Ashwini; Othman, Bayan Al; Lee, Andrew G.

doi:10.1016/j.jcjo.2019.07.007

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…Bilateral abducens palsy is the next most common ophthalmic finding, followed by conjugate gaze palsies, more frequently horizontal than vertical. 17,18 Unilateral internuclear ophthalmoplegia has been rarely reported, 19 but bilateral is especially rare, and only one case could be found. 20 One might expect complete ophthalmoplegia to be common in WE since it is often mentioned as part of the classic triad.…”

Section: Neuro-ophthalmic Findingsmentioning

confidence: 99%

<p>Neuro-ophthalmic Manifestations of Wernicke Encephalopathy</p>

Isen¹,

Kline²

2020

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Wernicke encephalopathy (WE) is a life-threatening but reversible syndrome resulting from acute thiamine deficiency that is frequently overlooked and underdiagnosed. It is classically characterized by a triad of ocular dysfunction, ataxia, and altered mental status. However, less than 1/3 patients have the complete triad, so it is crucial to have a high index of suspicion. Awareness of the early signs of WE is essential to prevent clinical progression, as patients with the full triad already have a profoundly thiamine-deficient state. This review highlights the neuro-ophthalmic manifestations of WE to guide the clinician in identifying the condition. In addition, we provide an update regarding the clinical characteristics, pathophysiology, neuroimaging and laboratory findings, treatment options, and prognosis of WE.

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Section: Neuro-ophthalmic Findingsmentioning

confidence: 99%