Abstract
Wernicke's disease, due to a thiamine deficiency, is characterized by nystagmus, palsy of abducens and conjugate gaze, gait ataxia and mental disorders. Caudal to the diencephalon, the neuropathologic lesions are located in four areas: (1) The periaquaeductal region, (2) the upper pons, (3) the upper medulla and (4) the cerebellum. This topography suggests an alteration of the brainstem auditory evoked responses (BAER). Following an appropriate acoustic stimulus, BAER reflect electrical events in the ascending auditory pathways within the brainstem.In seven patients studied, BAER were found to be abnormal in six cases. Corresponding to improvement of gaze palsy, respectively vertical nystagmus and palsy of abducens, BAER normalized in two cases, documenting the therapeutic efficacy of thiamine. In one case, however, nystagmus persisted and BAER remained abnormal. One case, studied after improvement of ocular symptoms, had normal BAER.Normalization of BAER, corresponding to improvement of ocular symptoms, ...
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