Abstract
Wernicke encephalopathy is caused by vitamin B1 deficiency. It presents as a triad consisting of altered mental status, oculomotor dysfunction, and gait ataxia. Early vitamin B1 administration alleviates symptoms. We present a video of gaze‐evoked nystagmus in an elderly patient with Wernicke encephalopathy.
Keywords: nystagmus, vitamin B1, Wernicke encephalopathy
Short abstract
It is often difficult to evaluate the mental and ambulatory states of frail elderly patients with dementia. In such cases, nystagmus is the only useful physical finding in the diagnosis of Wernicke encephalopathy.
An 86‐year‐old woman with dementia presented with a 6‐week history of poor appetite. Ten days ago, she was bedridden. On admission, she exhibited bilateral horizontal gaze‐evoked nystagmus (Video S1). Wernicke encephalopathy was suspected, and vitamin B1 was administered intravenously. Her nystagmus improved the following day (Video S2) and disappeared two weeks later (Video S3). Her serum vitamin B1 level was 1.0 μg/dl. The Wernicke encephalopathy triad includes mental status alteration, oculomotor dysfunction, and gait ataxia. 1 In frail elderly patients with dementia, mental and ambulation states are difficult to evaluate and nystagmus is the only useful physical finding in the diagnosis. 2
CONFLICT OF INTEREST
The authors declare that they have no competing interests.
AUTHOR CONTRIBUTIONS
SS collected the data and wrote the first draft of the manuscript. HN coordinated the project and edited the manuscript. Both authors have read and approved the final manuscript.
ETHICAL APPROVAL
Our IRB did not require further approval.
CONSENT
Written informed consent was obtained from the patient.
Supporting information
Video S1
Video S2
Video S3
ACKNOWLEDGMENT
We would like to thank Editage (www.editage.com) for English language editing.
Shirota S, Nishioka H. Gaze‐evoked nystagmus in Wernicke encephalopathy. Clin Case Rep. 2022;10:e05615. doi: 10.1002/ccr3.5615
Funding information
This work did not receive any specific grant from agencies in the public, commercial or not‐for‐profit sectors
DATA AVAILABILITY STATEMENT
Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.
REFERENCES
- 1. Isen DR, Kline LB. Neuro‐ophthalmic manifestations of Wernicke encephalopathy. Eye Brain. 2020;12:49‐60. doi: 10.2147/EB.S234078 [DOI] [PMC free article] [PubMed] [Google Scholar]
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Video S1
Video S2
Video S3
Data Availability Statement
Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.