Bithalamic Dysfunction in Wernicke’s Encephalopathy

Hiroki Nariai, Eric Mittelmann, Constantine Farmakidis, Richard L. Zampolin, Matthew S. Robbins


We describe a 65-year-old, nonalcoholic, right-handed female with multiple vascular risk factors who developed transient visuospatial hemineglect and global aphasia after presenting with the classic triad of Wernicke’s encephalopathy (mental status changes, nystagmus/ophthalmoplegia, and ataxia). A brain MRI showed no evidence of acute infarction, but demonstrated signal change in the medial thalami and mammillary bodies. Intravenous thiamine therapy was given, and visuospatial hemineglect and ophthalmoplegia disappeared while the aphasia improved. The occurrence of these acute transient clinical features has not been previously reported in Wernicke’s encephalopathy. 


Wernicke’s encephalopathy; encephalopathy; thiamine therapy

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