Open Access Mini Review

Good Response to Thiamine in Bilateral Thalamic Infarction Simulating a Wernicke Syndrome: Does it Has a Role in Acute Stroke?

Vargas Cañas, Alberto1,2*, Velásquez Mauricio1, Martínez Alejandro1and Valencia Javiera3

1Neurology Unit, Hospital Luis Tisné, Santiago, Chile

2Medicine School, University of Los Andes, Santiago, Chile

3Internal Medicine Fellowship, University of Los Andes, Santiago, Chile

Corresponding Author

Received Date: May 17, 2021;  Published Date: June 24, 2021

The classic clinical triad of Bilateral Thalamic Infarction is consciousness compromise, ocular motility disturbances, and cognitive deterioration; and would be an obligatory differential diagnosis of Wernicke´s Syndrome, which usually has, as clinical findings, altered mental status, ataxic gait and ophtalmoplegia. While Wernicke´s Syndrome is frequently associated with alcohol intake, it is known that there are some cases not related to alcohol consumption, these subtypes are called atypical non-alcoholic Wernicke´s Syndrome and are provoked by malnutrition as their most important etiology. Clinical case: female patient, admitted to our hospital with sudden installation of postural instability, tendency to drowsiness, nausea, dysarthria and provoked-type confabulation, initially diagnosed as an atypical non-alcoholic Wernicke´s Syndrome, with a first cerebral tomography without alterations and good response to thiamine infusion. In a second image study, a Bilateral Thalamic Infarction was evidenced. According to many reviews, the use of thiamine in acute stroke is not useful; and would be recommended in the neuro-rehabilitation phase. The clinical regression of symptoms and signs, in our patient, would be the natural history of some series of patients with Bilateral Thalamic Infarction described in the literature; but, we propose that it could also be explained in a bilateral thalamic dysfunction previously described in Wernicke´s Syndrome, and its fast response to thiamine use; so it would be interesting publishing more clinical reports or trials using thiamine in this specific type of stroke.

Keywords:Bilateral Thalamic Infarction; Wernicke Syndrome; Thiamine; Acute Stroke

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