2012/01/01 by Yui Kishimoto, Ken Ikeda, Kiyoko Murata +3 · 1 citation
Medicine · #Alcoholism and Thiamine Deficiency #Electrolyte and hormonal disorders #Neurological and metabolic disorders
paper · pdf · doi:10.2169/internalmedicine.51.7498
openalex publication_date 2012/01/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/31
We describe a non-alcoholic diabetic patient with central pontine myelinolysis (CPM) and Wernicke encephalopathy (WE). A 69-year-old man developed consciousness disturbance after parenteral hyperalimentation for liver abscess and sepsis. Neurological examination revealed drowsiness and no articulation. MRI disclosed T2-hyperintense lesions in the dorsal medulla oblongata and dentate nuclei, and symmetric enhancement in the inferior colliculus. Thiamine treatment (1,000 mg/day, div) attenuated neurological deficits. Seven days later, WE-related lesions were markedly regressed and a central pontine T2-hyperintensity lesion appeared. Serum sodium levels were normal. Physicians should pay more attention to rapid development of normonatremic CPM under thiamine supplementation in non-alcoholic WE patients.