輪液で発症したウェルニッケ脳症の２症例

Abstract

We report here 2 cases of Wernicke's encephalopathy following the use of an intravenous solution that did not contain any Vit. B1.Case 1 was a 69-year-old woman who had undergone an operation for an early stage gastric cancer, and had received an intravenous solution deficient in Vit. B1. Thirty-three days after the operation, symptoms such as dizziness, nystagmus, disorientation and dyspnea were observed.A brain MRI showed a high intensity signal in the periaqueductal area, and Wernicke's encephalopathy was suspected. An ENG test revealed lateral gaze nystagmus, and Caloric testing was negative bilaterally.Case 2 was a 23-year-old man who had suffered from Crohn's disease for the past 4 years. He also received the intravenous solution without Vit. B1 due to an ileus which had occurred. Twentyseven days after the onset of the IVH, he developed dizziness, nystagmus, gait disturbances, disturbances of short term memory and ataxia. A brain MRI showed a high intensity signal in the periaqueductal area. An ENG test showed lateral gaze nystagmus, and Caloric testing was negative bilaterally. He was therefore suspected with Wernicke's encephalopathy.The incidence of Wernicke's encephalopathy following treatment with a solution that does not contain Vit. B1 seems to be increasing MRI findings and neuro-otological signs are useful for an early diagnosis of Wernicke's encephalopathy.