TY -的T1 -韦尼克脑病伪装成右大脑中动脉梗塞(P6.012) JF -神经学乔-神经学六世- 90 - 15补充SP - P6.012盟Chi-Ying林盟- Ji Yeoun Yoo AU -阿米什Doshi盟瑞秋科尔曼Y1 - 20首页18/04/10 UR - //www.ez-admanager.com/content/90/15_Supplement/P6.012.abstract N2 -目的:描述的韦尼克脑病(我们)看到右大脑中动脉梗死的症状与体征与普通的MRI和脑电图。背景:我们的经典三包含改变精神状态,小脑性共济失调,眼肌麻痹。只有不到三分之一的我们有充分的表现。改变精神状态通常发生在至少92%的autopsy-proven我们,但异常extra-ocular运动中观察到只有50%。脑部核磁共振成像的灵敏度是50%左右。血液硫胺素水平可能不能准确地代表大脑的水平。设计/方法:图表回顾。结果:一个61岁的老人与酒精性肝硬化自发性细菌性腹膜炎承认历史,感染性休克,呼吸衰竭状态后插管。言语刺激他的神经系统检查显示没和胸骨摩擦,不断向右共轭凝视偏差,减少眨眼,威胁在左边,一个软弱的左胳膊,更积极在左肱二头肌和肱桡肌反射,和一个上行左脚趾足底反射测试。核磁共振大脑和MRA的头部和颈部显示没有急性或亚急性梗死,或明显狭窄。连续脑电图显示弥漫性放缓背景无痫性放电。我们当时怀疑危重患者高度消费状态。 His consciousness and gaze deviation remarkably improved after intravenous thiamine repletion. Additional review of MRI T2 FLAIR demonstrates hyperintense signal within the periaqueductal grey matter and bilateral mammillary bodies. Whole blood thiamine level tested before the repletion was 80 nmol/L (70–180). Despite the neurological improvement, he eventually passed away due to severe gastrointestinal bleeding.Conclusions: Lack of classic triad, neuroimaging findings, and low normal thiamine level cannot exclude the possibility of WE. WE should be highly suspected in patients with risk factors who develop change in consciousness. Prompt initiation of intravenous thiamine is crucial to reverse WE.Disclosure: Dr. Lin has nothing to disclose. Dr. Yoo has nothing to disclose. Dr. Doshi has nothing to disclose. Dr. Colman has nothing to disclose. ER -