Annals of Indian Academy of Neurology
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CASE REPORT
Year : 2014  |  Volume : 17  |  Issue : 1  |  Page : 103-105

Atypical Wernicke's syndrome sans encephalopathy with acute bilateral vision loss due to post-chiasmatic optic tract edema


1 Department of Neuromedicine, Pramukhswami Medical College and Shree Krishna Hospital, Karamsad, Anand, Gujarat, India
2 Department of Radiology, Pramukhswami Medical College and Shree Krishna Hospital, Karamsad, Anand, Gujarat, India

Correspondence Address:
Soaham Dilip Desai
Department of Neuromedicine, Pramukhswami Medical College and Shree Krishna Hospital, Karamsad, Anand - 388 325, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.128567

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A middle aged male presented with acute bilateral vision loss, 4 weeks after undergoing gastric bypass surgery for gastric carcinoma. He had normal sensorium, fundoscopy, normal pupillary reaction to light, but had mild opthalmoparesis and nystagmus with ataxia. Magnetic resonance imaging of the brain revealed post-chiasmatic optic tract edema along with other classical features of Wernicke's syndrome. Thiamine supplementation leads to complete resolution of clinical as well as imaging findings. In appropriate clinical settings, a high index of suspicion and early treatment are essential for managing Wernicke's syndrome even in patients with atypical clinical and imaging presentation.


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