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Wernicke Encephalopathy in a Patient with T-Cell Leukemia and Severe Malnutrition

Published online by Cambridge University Press:  02 December 2014

Lynn Lacasse
Affiliation:
Neuroradiology, Division of Radiology, The Ottawa Hospital-Civic Campus, Ottawa, Ontario, Canada
Cheemun Lum
Affiliation:
Neuroradiology, Division of Radiology, The Ottawa Hospital-Civic Campus, Ottawa, Ontario, Canada
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The patient was a 20-year-old male with an eight-month history of T-cell acute lymphoblastic leukemia (ALL). He presented to the emergency room with confusion and decreased level of consciousness that had worsened over the prior two weeks. He complained of generalized fatigue, weakness, intermittent nausea and vomiting and depression. His diet had consisted of only soda pop over the six weeks preceding admission.

The patient was disoriented and had a depressed level of consciousness. He appeared pale, cachectic, and had poor hygiene. Examination of the central nervous system showed lateral nystagmus and slowed motor activity in the both upper and lower extremities. Reflexes were bilaterally 2+ except at the ankles where they were 1+. Plantar responses were bilaterally downgoing.

Type
Research Article
Copyright
Copyright © The Canadian Journal of Neurological 2004

References

1.Gallucci, M, Bozzao, A, Splendiani, A, et al.Wernickeencephalopathy: MR findings in five patients. AJNR 1990; 11:887892.Google Scholar
2.Wilson, JD.Vitamin deficiency and excess. In: Fauci, AS, Braunwald, E, Isselbacher, KJ, et al (Eds). Harrison’s Principles of Internal Medicine, 14th Edition: McGraw-Hill 1998: 482483.Google Scholar
3.D’Aprile, P, Tarantino, A, Santoro, N, Carella, A.Wernicke’sencephalopathy induced by total parenteral nutrition in patient with acute leukemia: unusual involvement of caudate nuclei and cerebral cortex on MRI. Pediatric Neuroradiology 2000; 42:781783.Google ScholarPubMed
4.Park, SH, Manho, K, Duk, LN, Beom, SJ.Magnetic resonance reflectsthe pathological evolution of Wernicke encephalopathy. J Neuroimaging 2001; 11:406411.Google Scholar
5.Shogry, MEC, Curnes, JT.Mamillary body enhancement on MR asthe only sign of acute Wernicke encephalopathy. AJNR 1994; 15:172174.Google Scholar
6.Antunez, E, Estruch, R, Cardenal, C, et al.Usefulness of CT and MRimaging in the diagnosis of acute Wernicke's encephalopathy. AJR 1998; 171:11311137.Google Scholar
7.Doherty, MJ, Watson, NF, Uchino, K, Hallam, DK, Cramer, SC.Diffusion abnormalities in patients with Wernicke encephalopathy. Neurology 2002;58:655657.CrossRefGoogle ScholarPubMed
8.Bergui, M, Bradac, GB, Zhong, J.Diffusion abnormalities andWernicke encephalopathy. Neurology 2003;60:727728.Google Scholar
9.Bergui, M, Bradac, GB, Zhong, JJ, et al.Diffusion-weighted MR inreversible Wernicke encephalopathy. Neuroradiology 2001;43:969972.Google Scholar
10.Brody, BA.The Wernicke-Korsakoff syndrome: neuropathology andpathogenic basis. Int J Neuroradiology 1996; 2:216230.Google Scholar
11.Witt, ED.Neuroanatomical consequences of thiamine deficiency: acomparative analysis. Alcohol Alcohol 1985;2:201221.Google Scholar