Bilateral Paramedian Thalamic Infarction : Mimicking Wernicke                 Encephalopathy

J Korean Neurol Assoc > Volume 14(2); 1996 > Article

Journal of the Korean Neurological Association 1996;14(2): 572-575.

베르니케 뇌증과 유사한 양측성 방정중 시상 경색

정승철, 황성희, 이일형, 김상윤, 이병철

한림대학교 의과대학 신경과학교실

Bilateral Paramedian Thalamic Infarction : Mimicking Wernicke Encephalopathy

Seung Cheol Jeong, M.D., Sung-Hee Hwang, M.D., Il Hyung Lee, M,D., Sang Yun Kim, M.D., Byung Chul Lee, M.D.

Department of Neurology, Hallym University College of Medicine

Abstract

A 48-year-old man was admitted due to sudden disorientation and dysarthria. He has been drinking almost everyday for the past 25 years. At the time of the admission, he was alert but confused. Neurologic examination revealed disorientation to time, memory disturbances, decreased amount of speech, dysarthria, limitation of extraocular movement, ataxia of left limbs, and unsteady gait. He was treated with thiamine under the impression of Wernick's encephalopathy. Ataxia of limbs and unsteady gait improved but limitation of extraocular movement and disturbed higher cortical function remained. MRI of the brain taken 24 hours after the onset showed asymmetrical bilateral paramedian thalamic high signal lesions on 72-weighted images. We report here a case of bilateral paramedian thalamic infarction clinically mimicking Wernicke's encephalopathy.