非酒精性Wernicke脑病二例

目的探讨Wernicke脑病患者的临床和影像学特点。方法分析2例非酒精性Wernicke脑病患者的临床资料。结果 2例患者均为消化道晚期肿瘤行手术治疗、术后有营养不均衡、发病前有葡萄糖注射液补液史。2例患者均有意识障碍和典型的头颅MRI信号改变,即双侧丘脑内侧、中脑顶盖及导水管周围的高T_2信号;维生素B_1补充治疗后患者的症状有不同程度的好转。结论导致维生素B_1缺乏的高危因素、临床表现及典型的头颅MRI表现是临床上Wernicke脑病早期诊断的重要线索。早期足量维生素B_1治疗效果好。高危患者应注意预防Wernicke脑病的发生。

Clinical and imaging features of nonalcoholic Wernicke's encephalopathy

Objective To study the clinical and imaging features of Wernicke's encephalopathy(WE). Method The clinical data of 2 cases with nonalcoholic WE were analyzed retrospectively.Results Two patients had certain etiologies such as advanced neoplasia and surgical procedures of digestive system, unbalanced nutrition and intravenous infusion of glucose. Both cases had mental changes and typical findings in cranial MRI images :bilateral and symmetrical T2W and FLAIR(Fluid Attenuation Inversion Recovery) hyperintensities in medial thalamus,tectal plate and periaqueductal area.With thiamine(vitamin B1)supplement,symptoms were reversed with different extent. Conclusion Predisposing factors of thiamine deficiency,clinical manifestations and typical cranial MR images will give important clues for earlier diagnosis of WE. WE has a good outcome with adequate and prompt thiamine supplement. More attention should be paid to prevent the occurrence of WE in the high-risk patients.