DDx
Diagnostic Considerations
Because WE is reversible, the diagnosis of subclinical cases permits treatment and, probably, improvement of the patient's nutritional, metabolic, and neurological status. [13]
Consider acute WE in all alcoholic patients with any neurologic symptoms, especially in those with evidence of caloric or protein malnutrition or of peripheral neuropathy. Conditions to include in the differential diagnosis of WE include the following:
-
Psychosis
-
Normal pressure hydrocephalus
-
Cerebrovascular accident
-
Chronic hypoxia
-
Closed-head injury
-
Hepatic encephalopathy
-
Postictal state
Differential Diagnoses
-
Stroke, Ischemic
Media Gallery
-
This MRI shows typical high signal intensities (SIs) in the medial thalamus (A), periaqueductal gray (B), mamillary bodies (C), cerebellar vermis (B, C, D), and paravermian superior cerebellum (D). All the lesions represent high SIs on the DWI (E–H). The ADC images of the cerebellar vermis (K, L) and paravermian superior cerebellum (L) show low SIs (arrowheads), whereas other described areas (I, J) show iso-SIs (arrows). Image courtesy of Neurology. Apr 8 2008;70(15):e48.
of
1