Abstract
A 66-year-old male with habitual alcohol drink complained acute deterioration of left-side muscle weakness as initial presentation. On the arrival, the patient was confused, with stable vital sign and unremarkable pyramidal sign. Although several potential diagnoses could be considered, brain computed tomography did not provide diagnostic information, and subsequently-performed magnetic resonance imaging revealed hyperintense lesions on T2-flair images in corpus callosum, suggesting MBD as clinical diagnosis. Prompt diagnosis enabled us to introduce thiamine administration with subsequent favorable neurological outcome.
CASE
A 66-year-old male with habitual alcohol drink complained acute deterioration of left-side muscle weakness as initial presentation. On the arrival, the patient was confused, with stable vital sign (blood pressure 141/96mmHg, pulse rate 99/min, body temperature 37.2 ℃) and unremarkable pyramidal sign. Body mass index was 19.5 kg/m2 and decreased skin turgor suggested moderate dehydration. Although several potential diagnoses could be considered, brain computed tomography did not show any diagnostic information, other than ambiguous low-density area along with corpus callosum. We subsequently performed magnetic resonance imaging and found hyperintense lesions of both corpus callosum on T2-flair images and splenium on diffusion-weighted images (Figure), suggesting MBD as clinical diagnosis. The patient was treated initially with intravenous infusion including vitamin B1, and switched to its oral supplementation along with alcohol cessation. In response to the treatment, consciousness disturbance had been much improved within 12 hours after the thiamine supplementation, and no neurological deficit remains after 10 days hospital stay.