The Relationship Between Imageologic Changes And Clinical Features In28Cases Of Wernicke Encephalopathy

Objective To study the relationship between imageologic changes and clinical featuresin Wernicke encephalopathy in order to improve the diagnosis and treatment of this disease.Methods A retrospective review was conducted of28cases of WE from2002.3to2011.10evaluated at general hospital of Ningxia medical university and branch courts ofcerebrovascular. This study conducts its clinical features, imaging examination results, othercheck results, diagnostic methods and treatment effect.Results28patients were divided into two groups: Alcoholics (AL,7patients) andnon-alcoholics (NA,21patients). In AL, the most frequent clinical feature was mentalconfusion (85.71%)； Eye symptoms is in the second, the proportion is71.43%；theproportion of Ataxia、peripheral neuropathy and typical triad is the same as are57.14%; themost common MRI lesions were located in the fourth ventricle、sylvius aqueduct、in thethalami and periventricular area、the frontal and parietal cortex area(66.67%). In NA, themost frequent clinical feature was mental confusion too (52.38%); The proportion ofperipheral neuropathy is42.86%, the typical triad was not least in NA (23.81%); the mostcommon MRI lesions were located in the thalami and periventricular area (64.29%), theproportion of the fourth ventricle and sylvius aqueduct is42.86%. The rate in the MRIunenhancement of the frontal and parietal cortex area was significantly higher in AL than inNA (P=0.012). Once clinically suspected patients suffering from Wernicke encephalopathywho should be immediately intramuscular injection of vitamin B1100mg（Skin test negative）. The central nervous system damage of the patients whose lesions confined to the medicalthalamus、the bottom of the fourth ventricle、the third ventricle and the aqueduct on MRI isreversible. After5-20days of intramuscular injection of vitamin B1,14patients withneurological symptoms improved significantly.Conclusion Wernicke encephalopathy is an acute or subacute neurologic disorderresulting from vitamin B1defciency. Wernicke encephalopathy is lack of characteristicclinical representation in the early stage. So it is easy to be misdiagnosed. It should raiseawareness of the disease. Those patients who can not eat properly with not be explainedmental confuse, opthalnioplegia or dystaxia should be suspected the possibility of WE. Givingsufficient vitamin B1timely is the key treatment of this disease. MRI is worthful fordiagnosis.