title: Epileptic seizures as the first symptom of Wernicke's encephalopathy with cerebral cortical lesions.
abstract: Wernicke's encephalopathy (WE) is acute metabolic disease of the central nervous system caused by deficiency of thiamine. Typical imaging findings are bilateral and symmetric signal in mammillary bodies, medial thalamus and periaqueductal gray. We present a 45-year-old man diagnosed for WE with two seizures and unconsciousness. The magnetic resonance imaging showed bilateral and symmetrical signal hyper-intensities in the frontal and parietal cortex, in addition to the classical MRI findings of WE. Cortical damage in WE is rare. The patient was improved significantly from unconsciousness to obeying commands and answering questions after 3days by thiamine supplementation. But the muscle strength and conscious state did not improve after 1year. This case report reminds us that we should take into account the possibility of WE when imaging shows cortical damage.
authors.affiliation: Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Kailei
authors.initials: K
authors.lastname: Fu
authors.affiliation: Department of Geriatrics, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning, China.
authors.forename: Li
authors.initials: L
authors.lastname: Tian
authors.affiliation: Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Weishuang
authors.initials: W
authors.lastname: Xue
authors.affiliation: Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China. Electronic address: tengweiyucmu@126.com.
authors.forename: Weiyu
authors.initials: W
authors.lastname: Teng
mesh_terms: D003937:Diagnosis, Differential; D004827:Epilepsy / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010296:Parietal Lobe / Q000000981:diagnostic imaging; D012640:Seizures / Q000175:diagnosis* / Q000000981:diagnostic imaging; D013788:Thalamus / Q000000981:diagnostic imaging; D014899:Wernicke Encephalopathy / Q000175:diagnosis* / Q000000981:diagnostic imaging
keywords: Cerebral cortex; Epileptic seizures; Prognosis; Wernicke’s encephalopathy