Nystagmus and abducens nerve palsy as an early presentation of non-alcoholic Wernicke encephalopathy

Wernicke encephalopathy (WE) is a rare but life-threatening syndrome that is commonly associated with chronic alcoholism. It has also been found to be associated with malnutrition, prolonged parenteral nutrition, hemodialysis, hyperemesis gravidarum, gastroplasty, and AIDS. It usually presents as a...

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Main Authors: Darussalam, Siti Hajar, Mohd Isa, Muhammad, Md Saleh, Rafidah, Mohmood, Adzleen, Mohammad Razali, Amirah
Format: Article
Published: Springer Science and Business Media 2024
Online Access:http://psasir.upm.edu.my/id/eprint/117138/
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author Darussalam, Siti Hajar
Mohd Isa, Muhammad
Md Saleh, Rafidah
Mohmood, Adzleen
Mohammad Razali, Amirah
author_facet Darussalam, Siti Hajar
Mohd Isa, Muhammad
Md Saleh, Rafidah
Mohmood, Adzleen
Mohammad Razali, Amirah
author_sort Darussalam, Siti Hajar
building UPM Institutional Repository
collection Online Access
description Wernicke encephalopathy (WE) is a rare but life-threatening syndrome that is commonly associated with chronic alcoholism. It has also been found to be associated with malnutrition, prolonged parenteral nutrition, hemodialysis, hyperemesis gravidarum, gastroplasty, and AIDS. It usually presents as a clinical triad of confusion, ophthalmoplegia, and gait ataxia. Nystagmus is usually the most common and earliest ophthalmologic sign. We report a case of non-alcoholic WE in a patient who had prior bariatric surgery and was treated for malnutrition and sepsis, with nystagmus being the initial presentation. The MRI of the brain was normal. The diagnosis of WE was made clinically and was supported by the patient's symptomatic and clinical recovery following intravenous thiamine treatment. It is essential to highlight that a high level of suspicion is needed to diagnose non-alcoholic WE to allow the commencement of appropriate treatment and reduce morbidity and mortality rates related to this condition.
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spelling upm-1171382025-04-29T04:06:16Z http://psasir.upm.edu.my/id/eprint/117138/ Nystagmus and abducens nerve palsy as an early presentation of non-alcoholic Wernicke encephalopathy Darussalam, Siti Hajar Mohd Isa, Muhammad Md Saleh, Rafidah Mohmood, Adzleen Mohammad Razali, Amirah Wernicke encephalopathy (WE) is a rare but life-threatening syndrome that is commonly associated with chronic alcoholism. It has also been found to be associated with malnutrition, prolonged parenteral nutrition, hemodialysis, hyperemesis gravidarum, gastroplasty, and AIDS. It usually presents as a clinical triad of confusion, ophthalmoplegia, and gait ataxia. Nystagmus is usually the most common and earliest ophthalmologic sign. We report a case of non-alcoholic WE in a patient who had prior bariatric surgery and was treated for malnutrition and sepsis, with nystagmus being the initial presentation. The MRI of the brain was normal. The diagnosis of WE was made clinically and was supported by the patient's symptomatic and clinical recovery following intravenous thiamine treatment. It is essential to highlight that a high level of suspicion is needed to diagnose non-alcoholic WE to allow the commencement of appropriate treatment and reduce morbidity and mortality rates related to this condition. Springer Science and Business Media 2024 Article PeerReviewed Darussalam, Siti Hajar and Mohd Isa, Muhammad and Md Saleh, Rafidah and Mohmood, Adzleen and Mohammad Razali, Amirah (2024) Nystagmus and abducens nerve palsy as an early presentation of non-alcoholic Wernicke encephalopathy. Cureus. ISSN 2168-8184 https://www.cureus.com/articles/211394-nystagmus-and-abducens-nerve-palsy-as-an-early-presentation-of-non-alcoholic-wernicke-encephalopathy 10.7759/cureus.52121
spellingShingle Darussalam, Siti Hajar
Mohd Isa, Muhammad
Md Saleh, Rafidah
Mohmood, Adzleen
Mohammad Razali, Amirah
Nystagmus and abducens nerve palsy as an early presentation of non-alcoholic Wernicke encephalopathy
title Nystagmus and abducens nerve palsy as an early presentation of non-alcoholic Wernicke encephalopathy
title_full Nystagmus and abducens nerve palsy as an early presentation of non-alcoholic Wernicke encephalopathy
title_fullStr Nystagmus and abducens nerve palsy as an early presentation of non-alcoholic Wernicke encephalopathy
title_full_unstemmed Nystagmus and abducens nerve palsy as an early presentation of non-alcoholic Wernicke encephalopathy
title_short Nystagmus and abducens nerve palsy as an early presentation of non-alcoholic Wernicke encephalopathy
title_sort nystagmus and abducens nerve palsy as an early presentation of non-alcoholic wernicke encephalopathy
url http://psasir.upm.edu.my/id/eprint/117138/
http://psasir.upm.edu.my/id/eprint/117138/
http://psasir.upm.edu.my/id/eprint/117138/