Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1161-1162
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The vestibulo-ocular reflexes during head impulse in Wernicke’s encephalopathy
Department of Neurology, College of Medicine, Seoul National University, Seoul National University Bundang Hospital, Korea
Correspondence to:
Dr Ji Soo Kim, Department of Neurology, College of Medicine, Seoul National University, Department of Neurology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea; jisookim@snu.ac.kr
| The first 150 words of the full text of this article appear below. |
Ocular motor findings in Wernicke’s encephalopathy (WE) include gaze evoked nystagmus (GEN), central positional nystagmus, weakness of abduction, internuclear ophthalmoplegia and horizontal or vertical gaze palsy to total ophthalmoplegia. Another feature of WE is vestibular paresis.1 2 Previous studies documented hypoactive vestibular responses to both caloric and rotational stimuli, and a short vestibulo-ocular reflex (VOR) time constant. To address differential susceptibility of individual semicircular canals (SCC) according to stimulation frequency, we measured high acceleration VOR of the individual SCC using head impulse manoeuvres, and the low frequency VOR using bithermal caloric and rotatory chair tests in two patients with WE.
A 63-year-old woman had undergone Whipple’s operation because of carcinoma of the ampulla of Vater 1 month previously and had received total parenteral nutrition (TPN). Two weeks after initiation of TPN, she began to suffer from anorexia, vomiting and vertigo which progressed to psychomotor slowing, apathy, forgetfulness and ataxia. On examination,
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