title: Evolution of abnormal eye movements in Wernicke's encephalopathy: correlation with serial MRI findings.
abstract: A 33-year-old woman with Wernicke's encephalopathy (WE) due to poor oral intake after allogeneic stem cell transplantation for acute myeloid leukemia showed a sequential development of bilateral gaze-evoked nystagmus (GEN), rightward gaze palsy, and upbeat nystagmus. Initial MRIs obtained when she had GEN only showed a lesion involving the medullary tegmentum, and follow-up MRIs revealed additional lesions in the pontine and midbrain tegmentum along with development of rightward gaze palsy, and finally bilateral medial thalamus lesions in association with upbeat nystagmus. The evolution of abnormal ocular motor findings and serial MRI changes in our patient with WE provide imaging evidence on relative vulnerability of the neural structures, and on the progression of lesions and ocular motor findings in thiamine deficiency.
authors.affiliation: Department of Neurology, Gachon University Gil Medical Center, Incheon, South Korea.
authors.forename: Kitae
authors.initials: K
authors.lastname: Kim
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Shin
authors.forename: Yeong-Bae
authors.initials: YB
authors.lastname: Lee
authors.forename: Kee-Hyung
authors.initials: KH
authors.lastname: Park
authors.forename: Hyeon-Mi
authors.initials: HM
authors.lastname: Park
authors.forename: Dong-Jin
authors.initials: DJ
authors.lastname: Shin
authors.forename: Ji-Soo
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000328:Adult; D001259:Ataxia / Q000209:etiology; D018450:Disease Progression; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000601:surgery; D008279:Magnetic Resonance Imaging; D044342:Malnutrition / Q000150:complications; D009759:Nystagmus, Pathologic / Q000209:etiology / Q000503:physiopathology*; D011149:Pons / Q000473:pathology / Q000503:physiopathology; D011183:Postoperative Complications / Q000209:etiology; D012074:Remission Induction; D033581:Stem Cell Transplantation; D013681:Tegmentum Mesencephali / Q000473:pathology / Q000503:physiopathology; D013788:Thalamus / Q000473:pathology / Q000503:physiopathology; D013831:Thiamine / Q000627:therapeutic use; D014717:Vertigo / Q000209:etiology; D014899:Wernicke Encephalopathy / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology*
chemical_list: D013831:Thiamine