title: [Paralysis of vertical gaze as a sequela of Wernicke's encephalopathy].
abstract: In the acute phase of Wernicke's encephalopathy the treatment with thiamine results quickly in a normal ocular motor function. In a patient with severe and long-time alcoholism, and poor nutrition, an acute Wernicke's disease is reported in which a complete gaze palsy was associated with cerebellar symptoms, desorientation and anterograde amnesia. The treatment by thiamine, pyridoxine and folic acid resulted in the disappearance, in 1 week, of the extra-ocular symptoms. Lateral gaze palsy disappeared in 3 weeks, but vertical gaze palsy was unchanged after 8 months. Eye movement disorders rarely persist more than 1 week in well-treated patients. In this case, clinical signs and course, computed tomography have excluded another disease of the midbrain (i.e.: tumor, infarct, centro-pontine myelinolysis.) Hypotheses are considered to account for this fact: first, subclinical lesions persisting after a similar episode three years before; second, an abnormality of the transcetolase enzyme system: third, the association of the thiamine deficiency with a possible toxicity of very odd fooding habits. This patient, since several months, ate nothing but spoiled food with an admixture of strong alcoholic beverages.
mesh_terms: D004359:Drug Therapy, Combination; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000209:etiology*; D011736:Pyridoxine / Q000008:administration & dosage; D013831:Thiamine / Q000008:administration & dosage; D014899:Wernicke Encephalopathy / Q000150:complications* / Q000188:drug therapy
chemical_list: D005492:Folic Acid; D011736:Pyridoxine; D013831:Thiamine
vernacular_title: Paralysie de la verticalité du regard séquellaire d'une encéphalopathie de Wernicke.