RT Journal Article
T1 Wernicke’s encephalopathy precipitated by neuromyelitis optica spectrum disorder and Graves’ disease: A tale of clinical and radiological dilemmas
A1 Ghosh, Ritwik
A1 Dubey, Souvik
A1 Ray, Adrija
A1 Roy, Dipayan
A1 De, Kaustav
A1 Mandal, Arpan
A1 Naga, Dinobandhu
A1 Swaika, Bikash Chandra
A1 Pandit, Alak
A1 Benito Leon, Julián
AB BackgroundNeuromyelitis optica spectrum disorder (NMOSD), an autoimmune astrocytopathy, may share common clinico-radiological features with Wernicke's encephalopathy (WE). A variant of NMOSD, known as area postrema syndrome (APS), that presents with intractable hiccups and associated vomiting, might lead to the depletion of nutrients if not detected and treated early. Autoimmune thyroid disorders (i.e., Graves’ disease) may be associated with NMOSD. Rarely, thyrotoxicosis can give rise to thiamine depletion and WE.Case presentationHere, we present a case of untreated hyperthyroidism in an Indian female who presented with thyrotoxicosis and later developed WE, possibly also contributed by NMOSD (APS)-induced recurrent vomiting. The patient recovered with antithyroid drugs, parenteral thiamine, and immunomodulatory therapy. The possible pathogenic mechanisms have been discussed.ConclusionOur case establishes the importance of considering NMOSD variants in metabolic encephalopathy, especially if neuroimaging is suggestive and in the backdrop of another autoimmune disorder.
PB Wiley
SN 1759-1961
YR 2021
FD 2021-07-16
LK https://hdl.handle.net/20.500.14352/4718
UL https://hdl.handle.net/20.500.14352/4718
LA eng
NO CRUE-CSIC (Acuerdos Transformativos 2021)
DS Docta Complutense
RD 3 may 2024