以急性意识障碍伴低血压为首发症状的非酒精性Wernicke脑病1例  

A case of non-alcoholic Wernicke encephalopathy with acute consciousness disturbance with hypotension as the first symptom

作　　者：张军 刘倩 杨军 ZHAGN Jun;LIU Qian;YANG Jun(Xiangyang No.1 People’s Hospital,Hubei University of Medicine,Xiangyang 441000,China)

机构地区：[1]湖北医药学院附属襄阳市第一人民医院,湖北襄阳441000

出　　处：《中国实用神经疾病杂志》2023年第9期1169-1172,共4页Chinese Journal of Practical Nervous Diseases

基　　金：湖北省自然科学基金(编号:2022CFD117);襄阳市科技计划项目(编号:2022YL22B)。

摘　　要：目的探讨Wernicke脑病尤其是非酒精性Wernicke脑病的少见临床表现。方法回顾1例非酒精性Wernicke脑病患者的临床表现、辅助检查、治疗过程及预后,并复习该病相关文献。结果该例非酒精性Wernicke脑病患者以急性意识障碍伴低血压为首发症状,头部核磁(MRI)平扫+弥散加权成像(DWI)提示四叠体、双侧丘脑、双侧乳头体异常信号影,给予VitB1等对症治疗后,该例患者的临床症状得到改善。结论以急性意识障碍伴低血压为首发症状的非酒精性Wernicke脑病患者经常被误诊。结合可导致VitB1缺乏的病史以及头部MRI等检查有助于尽早明确诊断,及时补充VitB1可有效改善患者的预后。Objective To investigate the rare clinical manifestations of Wernicke encephalopathy,especially non-alcoholic Wernicke encephalopathy.Methods The clinical manifestations,adjuvant examination,treatment process and prognosis of a patient with non-alcoholic Wernicke encephalopathy were reviewed,and the relevant literature was reviewed.Results In this patient with non-alcoholic Wernicke encephalopathy,acute consciousness disturbance with hypotension as the first symptom,head Magnetic Resonance Imaging(MRI)scan+diffusion weighted imaging(DWI)suggested quadruplex,bilateral thalamus and bilateral papillary body.After receiving VitB1 treatment,the clinical symptoms improved.Conclusion Patients with non-alcoholic Wernicke encephalopathy with acute consciousness disorder and hypotension as the first symptom are often misdiagnosed.Combined with the history of malnutrition that can lead to VitB1 deficiency and head MRI can help to clarify the diagnosis as soon as possible,and timely VitB1 supplementation can effectively improve the prognosis of patients.

关 键 词：意识障碍 低血压 非酒精性Wernicke脑病 

分 类 号：R742[医药卫生—神经病学与精神病学]