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[Case of Wernicke's encephalopathy and subacute combined degeneration of the spinal cord due to vitamin deficiency showing changes in the bilateral corpus striatum and cardiac arrest due to beriberi heart disease].
Brain Nerve. 2009 Sep; 61(9):1069-73.BN

Abstract

A 52-year-old woman was admitted to the hospital because of appetite loss, unsteadiness, psychogenic symptoms, ataxia, and consciousness disturbance as a result of the ingestion of a diet restricted to only carbohydrates for a long term. Laboratory examination indicated the presence of pancytopenia with macrocytic anemia; further, decreased vitamin B1 and B12 levels were detected in her serum. Magnetic resonance imaging fluid attenuated inversion recovery (FLAIR), revealed high-signal intensity in the bilateral corpus striatum, third ventricle circumference, and cerebellar cortex. Thereafter, she received drip infusion that did not include vitamin B1 or B12 and subsequently suffered a cardiac arrest due to the aggravation of cardiac insufficiency; consequently, she was transferred to our hospital. Upon admission the patient was diagnosed to have obvious cardiomegaly with pleural effusion; further, a negative T-wave was obtained on the electrocardiogram. A diagnosis of beriberi heart disease was made because of thiamine deficiency. She was treated by thiamine administration, following which the cardiac symptoms improved immediately. Various neurological symptoms caused by encephalopathy, peripheral neuropathy and subacute combined spinal cord degeneration improved by treatment with thiamine and cyanocobalamine administration; however, some of these symptoms still remained. General awareness of the fact that neurological symptoms can be caused by vitamin deficiency is essential.

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Authors+Show Affiliations

Ishiko T
Department of Neurology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji-shi, Tokyo 193-0998, Japan.
Taguchi T
No affiliation info available
Takeguchi M
No affiliation info available
Saito H
No affiliation info available
Nanri K
No affiliation info available

MeSH

BeriberiCardiomegalyCorpus StriatumFemaleFolic AcidFolic Acid DeficiencyHeart ArrestHumansMiddle AgedSubacute Combined DegenerationThiamineThiamine DeficiencyTreatment OutcomeVitamin B 12Vitamin B 12 DeficiencyWernicke Encephalopathy

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

jpn

PubMed ID

19803406

Citation

Ishiko, Tomoko, et al. "[Case of Wernicke's Encephalopathy and Subacute Combined Degeneration of the Spinal Cord Due to Vitamin Deficiency Showing Changes in the Bilateral Corpus Striatum and Cardiac Arrest Due to Beriberi Heart Disease]." Brain and Nerve = Shinkei Kenkyu No Shinpo, vol. 61, no. 9, 2009, pp. 1069-73.
Ishiko T, Taguchi T, Takeguchi M, et al. [Case of Wernicke's encephalopathy and subacute combined degeneration of the spinal cord due to vitamin deficiency showing changes in the bilateral corpus striatum and cardiac arrest due to beriberi heart disease]. Brain Nerve. 2009;61(9):1069-73.
Ishiko, T., Taguchi, T., Takeguchi, M., Saito, H., & Nanri, K. (2009). [Case of Wernicke's encephalopathy and subacute combined degeneration of the spinal cord due to vitamin deficiency showing changes in the bilateral corpus striatum and cardiac arrest due to beriberi heart disease]. Brain and Nerve = Shinkei Kenkyu No Shinpo, 61(9), 1069-73.
Ishiko T, et al. [Case of Wernicke's Encephalopathy and Subacute Combined Degeneration of the Spinal Cord Due to Vitamin Deficiency Showing Changes in the Bilateral Corpus Striatum and Cardiac Arrest Due to Beriberi Heart Disease]. Brain Nerve. 2009;61(9):1069-73. PubMed PMID: 19803406.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Case of Wernicke's encephalopathy and subacute combined degeneration of the spinal cord due to vitamin deficiency showing changes in the bilateral corpus striatum and cardiac arrest due to beriberi heart disease]. AU - Ishiko,Tomoko, AU - Taguchi,Takeshi, AU - Takeguchi,Masafumi, AU - Saito,Hirohiko, AU - Nanri,Kazunori, PY - 2009/10/7/entrez PY - 2009/10/7/pubmed PY - 2009/12/16/medline SP - 1069 EP - 73 JF - Brain and nerve = Shinkei kenkyu no shinpo JO - Brain Nerve VL - 61 IS - 9 N2 - A 52-year-old woman was admitted to the hospital because of appetite loss, unsteadiness, psychogenic symptoms, ataxia, and consciousness disturbance as a result of the ingestion of a diet restricted to only carbohydrates for a long term. Laboratory examination indicated the presence of pancytopenia with macrocytic anemia; further, decreased vitamin B1 and B12 levels were detected in her serum. Magnetic resonance imaging fluid attenuated inversion recovery (FLAIR), revealed high-signal intensity in the bilateral corpus striatum, third ventricle circumference, and cerebellar cortex. Thereafter, she received drip infusion that did not include vitamin B1 or B12 and subsequently suffered a cardiac arrest due to the aggravation of cardiac insufficiency; consequently, she was transferred to our hospital. Upon admission the patient was diagnosed to have obvious cardiomegaly with pleural effusion; further, a negative T-wave was obtained on the electrocardiogram. A diagnosis of beriberi heart disease was made because of thiamine deficiency. She was treated by thiamine administration, following which the cardiac symptoms improved immediately. Various neurological symptoms caused by encephalopathy, peripheral neuropathy and subacute combined spinal cord degeneration improved by treatment with thiamine and cyanocobalamine administration; however, some of these symptoms still remained. General awareness of the fact that neurological symptoms can be caused by vitamin deficiency is essential. SN - 1881-6096 UR - https://www.unboundmedicine.com/medline/citation/19803406/[Case_of_Wernicke's_encephalopathy_and_subacute_combined_degeneration_of_the_spinal_cord_due_to_vitamin_deficiency_showing_changes_in_the_bilateral_corpus_striatum_and_cardiac_arrest_due_to_beriberi_heart_disease]_ L2 - https://webview.isho.jp/openurl?rft.genre=article&rft.issn=1881-6096&rft.volume=61&rft.issue=9&rft.spage=1069 DB - PRIME DP - Unbound Medicine ER -