A Patient with Sub Acute Viral Hepatitis (HEV) and Nonalcoholic Wernicke’s Encephalopathy: A Case Report

Bangladesh Journal of Neuroscience Pub Date : 2018-01-31 DOI:10.3329/bjn.v34i1.57536

Md. Rafiqul Islam, Mohammad Saifullah Ahtesam, -. Md Wahiduzzaman, Md. Habibur Rahman, Md. Monirul Islam, D. Nath

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Abstract

Wernicke’s encephalopathy (WE) is an acute neurological disorder resulting from thiamine deficiency. It is mainly related to alcohol abuse but it can be associated with other conditions such as gastrointestinal disorders like hyperemesis. A 38-year-old man with acute viral hepatitis presented with severe weakness, yellow discoloration of the body, hyperemesis in addition with disorientation, horizontal and vertical gaze-evoked nystagmus. MRI of brain showed typical findings of WE. Adequate treatment with parenteral thiamine was given. Neurological symptoms (Disorientation, Nystagmus and Ataxia) ameliorated during hospital stay and radiological abnormalities markedly improved in a follow up MRI after 2 months. This case suggests that WE may be associated with hyperemesis in non-alcoholic patients. Early thiamine treatment in symptomatic patients may improve prognosis. This extraordinary presentation of WE with hyperemesis, encouraged us to presentthis case history. Bangladesh Journal of Neuroscience 2018; Vol. 34 (1): 52-57

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亚急性病毒性肝炎(HEV)合并非酒精性韦尼克脑病1例

韦尼克脑病(WE)是一种由硫胺素缺乏引起的急性神经系统疾病。它主要与酒精滥用有关，但也可能与其他疾病有关，如呕吐等胃肠道疾病。38岁男性，急性病毒性肝炎，表现为严重虚弱，身体变黄，呕吐，定向障碍，水平和垂直凝视诱发眼球震颤。脑MRI示典型WE征。给予充分的肠外硫胺素治疗。住院期间神经系统症状(定向障碍、眼球震颤和共济失调)得到改善，2个月后随访MRI影像学异常明显改善。本病例提示WE可能与非酒精患者的呕吐有关。有症状的患者早期服用硫胺素可改善预后。这一罕见的WE伴有剧吐，鼓励我们呈现这一病例的历史。孟加拉国神经科学杂志2018;Vol. 34 (1): 52-57

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Bangladesh Journal of Neuroscience

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