Atrophic mammillary bodies with hypointensities on susceptibility-weighted images: A case-study in Korsakoff syndrome

Korsakoff syndrome (KS) is a largely irreversible residual syndrome mainly caused by chronic and excessive alcohol consumption with thiamine deficiency [1]. Some of KS are occurring after incomplete recovery from Wernicke encephalopathy (WE), however some does not follow a clear-cut WE episode [2]. Because some patients have a more insidious onset, KS is diagnosed more commonly in alcoholics at post-mortem than it is in life [3]. Although magnetic resonance imaging (MRI) allows to visualise oedematous lesions in acute-phase WE, the neuroradiological diagnosis of chronic KS is difficult [4].
Source: Journal of the Neurological Sciences - Category: Neurology Authors: Tags: Letter to the Editor Source Type: research

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Gayet-Wernicke encephalopathy (WE) is an acute neurological disorder resulting from deficiency of thiamine, commonly related to chronic abuse of alcohol, but frequently missed or overlooked as a diagnosis when a nonalcoholic patient presents with atypical signs and symptoms of the disease. The diagnosis of the disease is clinical, and confirmation is done by magnetic resonance imaging. We aim to highlight a case of WE in a nonalcoholic postoperative surgical patient receiving total parental nutrition where high-dose intravenous administration of thiamine in time mitigated the symptoms of disease and prevented permanent neu...
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Report Source Type: research
CONCLUSION: Although WE is rare in children it can be prevented by early diagnosis and treatment and oculomotor findings such as diplopia can be a warning sign. PMID: 32419425 [PubMed - in process]
Source: The Turkish Journal of Pediatrics - Category: Pediatrics Authors: Tags: Turk J Pediatr Source Type: research
Abstract Wernicke encephalopathy (WE) is an acute neurological disorder resulting from vitamin B1 deficiency, which is common in chronic alcoholism and is rare in acute liver failure. So far, there are 2 cases of WE reported after liver transplantation. Here, we report a case of a 45-year-old nonalcoholic male patient who developed psychiatric and neurological disturbance 15 d after receiving orthotopic liver transplantation because of hepatitis B-related cirrhosis and portal hypertension. Brain magnetic resonance imaging (MRI) showed symmetric high-signal intensities in the periaqueductal area. The patient was di...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
This article focuses on MRI, DTI, and MRS findings in neurological disorders that commonly co-occur with alcoholism, including Wernicke's encephalopathy, Korsakoff's syndrome, and hepatic encephalopathy. Also reviewed are neuroimaging findings in animal models of alcoholism and related neurological disorders. This report also suggests that the dynamic course of alcoholism presents a unique opportunity to examine brain structural and functional repair and recovery. PMID: 28988573 [PubMed - in process]
Source: Alcohol Research - Category: Addiction Tags: Alcohol Res Source Type: research
Authors: Chen BA, Chen LC Abstract Wernicke's encephalopathy (WE) is a disease caused by thiamine deficiency related to alcoholism, hyperemesis, or thiamine malabsorption. The clinical manifestations of WE are mental change, ataxia, and ophthalmoplegia. The typical magnetic resonance imaging (MRI) findings of WE are symmetrical involvement of medial thalamus, periventricular region of the third ventricle, periaqueductal area, and mammillary body. The atypical MRI findings are more common in nonalcoholic WE. Since the increasing population of obesity and the preference of weight loss surgery, the risk of developing ...
Source: Acta Neurologica Taiwanica - Category: Neurology Tags: Acta Neurol Taiwan Source Type: research
In this study, we present the clinical manifestations, brain magnetic resonance imaging (MRI) and concurrent polyneuropathies in two patients with non-alcoholic Wernicke ’s encephalopathy (WE) after gastrojejunostomy (Billroth II) anastomosis procedures. These patients developed sub-acute onset of disorientation and disturbance of consciousness following several weeks of poor intake. Peripheral neuropathy of varying severity was noted before and after the onset of WE. Brain MRI of the patients showed cerebellar vermis and symmetric cortical abnormalities in addition to typical WE changes. Electrophysiological studies...
Source: Metabolic Brain Disease - Category: Neurology Source Type: research
We report a young woman with systemic lupus erythematosus (SLE) and an acute cerebellar ataxia. A history of poor appetite and vomiting preceded the inco-ordination. Ataxia in SLE has been well described, but is nevertheless uncommon. The clinical triad of mild confusion, ataxia and ophthalmoplegia also raised the possibility of Wernicke's encephalopathy (WE). The diagnosis of WE was further supported by the magnetic resonance imaging features. Owing to overlapping causal factors, this case illustrates the complexity of diagnosing and managing neuropsychiatric syndromes in a patient with SLE. The limite...
Source: South African Medical Journal - Category: African Health Tags: S Afr Med J Source Type: research
Conclusion In closing, our patient’s episode of TGA combined with her emotional and perceptual response lends credence to the proposal of a “fear/paranoia” circuit in the genesis of paranoid delusions—a circuit incorporating amygdala, frontal, and parietal cortices. Here, neutral or irrelevant stimuli, thoughts, and percepts come to engender fear and anxiety, while dysfunction in frontoparietal circuitry engenders inappropriate social predictions and maladaptive inferences about the intentions of others.[54] Hippocampus relays information about contextual information based on past experiences and th...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Anxiety Disorders Behavioral and Cognitive Neurology Case Report Cognition Current Issue Dementia Medical Issues Neurologic Systems and Symptoms Psychiatry Schizophrenia delusions hippocampus neurobiology Transient global amnesia Source Type: research
This 18-year-old man with a history of plasmablastic lymphoma and secondary hemophagocytic lymphohistiocytosis presented status post bone marrow transplant with acute onset of increasing somnolence, right hemiparesis, and seizures. A bedside electroencephalography showed normal findings. T2-weighted fluid-attenuated inversion recovery and diffusion-weighted magnetic resonance imaging (MRI) revealed symmetric signal hyperintensity and restricted diffusion involving the bilateral medial thalami, mammillary bodies, hypothalamus, tectum, left perirolandic cortex, and bilateral medial frontal cortex (Figure).
Source: Pediatric Neurology - Category: Neurology Authors: Tags: Visual Diagnosis Source Type: research
We present a case of a 40-year-old male who presented with confusion and difficulty in maintaining the balance while walking 3 months after Roux en Y gastric bypass surgery. Diagnosis of WE was made on clinical ground and confirmed by magnetic resonance imaging of the brain, which showed bilateral hyperintense signals in paramedian thalami. Parenteral thiamine replacement was started, and patient showed complete recovery. PMID: 26620994 [PubMed - in process]
Source: Saudi Medical Journal - Category: Middle East Health Tags: Saudi Med J Source Type: research
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