Editorial Comment: Ataxia, Ophthalmoplegia, and Impairment of Consciousness in a 19 Month-Old American Boy

The authors describe a classic neurologic syndrome in an unusual setting. Wernicke encephalopathy is most commonly encountered in malnourished adults, particularly those who abuse alcohol. It is not generally high in the differential diagnosis of childhood disorders, particularly in children who are otherwise ostensibly well, but it is critical to diagnose, owing to its potential reversibility with early treatment. This elegant report beautifully outlines the diagnostic process, differential diagnosis, and recognition of the key findings—the combination of acute ataxia and ophthalmoplegia with altered mental status as the hallmark of acute thiamine deficiency. The authors also emphasize the importance of a thorough evaluation of dietary history, which revealed the underlying nutritional deficiency in the child they describe. In this case, neuroimaging clinched the diagnosis before biochemical confirmation was available.

Source: Seminars in Pediatric Neurology - June 18, 2014 Category: Neurology Authors: Marc C. Patterson Source Type: research