Frontal lobe syndrome from bilateral globus pallidus lesions a complication of Wernicke's encephalopathy

Arruda, Walter Oleschko

doi:10.1590/S0004-282X1991000200018

Abstracts

A 38 year-old man developed the classical clinical picture of Wernicke's encephalopathy as a consequence of prolonged total parenteral nutrition. As a late complication he developed a frontal lobe syndrome. Bilateral globus pallidus lesions were observed in the CT-scan examination. Some aspects related to the cortical syndromes caused by subcortical lesions are discussed.

Relata-se um caso de encefalopatia de Wernicke que ocorreu em paciente masculino de 38 anos, como complicação de alimentação parenteral total. Houve boa recuperação clínica com suplementação de tiamina mas, como complicação neurológica tardia, o paciente desenvolveu quadro amnésico associado a síndrome de lobo frontal caracterizada por apatia, perseveração e alteração de testes de função cortical frontal. TC revelou presença de lesões bilaterais de globo pálido. São discutidos alguns aspectos relacionados ao desenvolvimento de síndromes corticais frontais em decorrência de lesões estruturais subcorticais.

CONTENTS CONTEÚDO

Walter Oleschko Arruda

Neurologist, Unidade de Ciências Neurológicas, Curitiba

SUMMARY

A 38 year-old man developed the classical clinical picture of Wernicke's encephalopathy as a consequence of prolonged total parenteral nutrition. As a late complication he developed a frontal lobe syndrome. Bilateral globus pallidus lesions were observed in the CT-scan examination. Some aspects related to the cortical syndromes caused by subcortical lesions are discussed.

RESUMO

Relata-se um caso de encefalopatia de Wernicke que ocorreu em paciente masculino de 38 anos, como complicação de alimentação parenteral total. Houve boa recuperação clínica com suplementação de tiamina mas, como complicação neurológica tardia, o paciente desenvolveu quadro amnésico associado a síndrome de lobo frontal caracterizada por apatia, perseveração e alteração de testes de função cortical frontal. TC revelou presença de lesões bilaterais de globo pálido. São discutidos alguns aspectos relacionados ao desenvolvimento de síndromes corticais frontais em decorrência de lesões estruturais subcorticais.

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Full text available only in PDF format.

Dr. Walter O. Arruda - Rua Gonçalves Dias 713 - 80240 Curitiba PR - Brasil

1. Baughman FA Jr, Papp JP. Wernicke's encephalopathy with intravenous hyperalimentation: remarks on similarities between Wernicke's encephalopathy and the phosphate depletion syndrome. Mt Sinai J Med 1976, 43:48.
2. Gibb WRG, Gorsuch AN, Lees AJ, Yudkin JS. Reversible coma in Wernicke's encephalopathy. Post Grad Med J 1985, 61:607.
3. Harper CG. Sudden, unexpected death and Wernicke's encephalopathy : a complication or prolonged intravenous feeding. Aust N Z J Med 1980, 10:230.
4. Harper CG, Giles M, Finlay-Jones R. Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy. J Neurol Neurosurg Psy-chiat 1986, 49:341.
5. Kitaguchi T, Kobayashy T, Tobimatsu S, Goto I, Kuroiwa Y. Computed tomography and magnetic resonance imaging in a young patient with Wernicke's encephalopathy. J Neurol 1987, 234:449.
6. Kramer J, Goodwin JA. Wernicke's encephalopathy : complication of intravenous hyperalimentation. JAMA 1977, 238:2176.
7. McDowell JR, LeBlanc HJ. Computed tomography findings in Wernicke-Korsakoff syndrome. Arch Neurol 1984, 41:453.
8. Mensing JWA, Hoogland PH, Sloof JL. Computed tomography in the diagnosis of Wernicke's encephalopathy: a radiological-neuropathological correlation. Ann Neurol 1984, 16:363.
9. Nadel AM, Burger PC. Wernicke encephalopathy following prolonged intravenous therapy. JAMA 1976, 235:2403.
10. Reuler JB, Girard BE, Cooney TG. Wernicke's encephalopathy. N Engl J Med 1985, 312:1035.
11. Strub RL. The Mental Status Examination in Neurology. Philadelphia: F.A. Davis, 1986.
12. Strub RL. Frontal lobe syndrome in a patient with bilateral globus pallidus lesions. Arch Neurol 1989, 46:1024.
13. Wallis WE, Willoughby E, Baker P. Coma in the Wernicke-Korsakoff syndrome. Lancet 1978, 2:400.
14 Wolfe N, Linn R, Babikian VL, Knoefel JE, Albert ML. Frontal systems impairment following multiple lacunar infarcts. Arch Neurol 1990, 47:129.

Frontal lobe syndrome from bilateral globus pallidus lesions a complication of Wernicke's encephalopathy

Síndrome de lobo frontal por lesões de globus pallidus bilaterais: complicação da encefalopatia de Wernicke.

Publication Dates

Publication in this collection
22 Feb 2011
Date of issue
June 1991

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Baughman FA Jr, Papp JP. Wernicke's encephalopathy with intravenous hyperalimentation: remarks on similarities between Wernicke's encephalopathy and the phosphate depletion syndrome. Mt Sinai J Med 1976, 43:48.

[2] 2. Gibb WRG, Gorsuch AN, Lees AJ, Yudkin JS. Reversible coma in Wernicke's encephalopathy. Post Grad Med J 1985, 61:607.

[3] 3. Harper CG. Sudden, unexpected death and Wernicke's encephalopathy : a complication or prolonged intravenous feeding. Aust N Z J Med 1980, 10:230.

[4] 4. Harper CG, Giles M, Finlay-Jones R. Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy. J Neurol Neurosurg Psy-chiat 1986, 49:341.

[5] 5. Kitaguchi T, Kobayashy T, Tobimatsu S, Goto I, Kuroiwa Y. Computed tomography and magnetic resonance imaging in a young patient with Wernicke's encephalopathy. J Neurol 1987, 234:449.

[6] 6. Kramer J, Goodwin JA. Wernicke's encephalopathy : complication of intravenous hyperalimentation. JAMA 1977, 238:2176.

[7] 7. McDowell JR, LeBlanc HJ. Computed tomography findings in Wernicke-Korsakoff syndrome. Arch Neurol 1984, 41:453.

[8] 8. Mensing JWA, Hoogland PH, Sloof JL. Computed tomography in the diagnosis of Wernicke's encephalopathy: a radiological-neuropathological correlation. Ann Neurol 1984, 16:363.

[9] 9. Nadel AM, Burger PC. Wernicke encephalopathy following prolonged intravenous therapy. JAMA 1976, 235:2403.

[10] 10. Reuler JB, Girard BE, Cooney TG. Wernicke's encephalopathy. N Engl J Med 1985, 312:1035.

[11] 11. Strub RL. The Mental Status Examination in Neurology. Philadelphia: F.A. Davis, 1986.

[12] 12. Strub RL. Frontal lobe syndrome in a patient with bilateral globus pallidus lesions. Arch Neurol 1989, 46:1024.

[13] 13. Wallis WE, Willoughby E, Baker P. Coma in the Wernicke-Korsakoff syndrome. Lancet 1978, 2:400.

[14] 14 Wolfe N, Linn R, Babikian VL, Knoefel JE, Albert ML. Frontal systems impairment following multiple lacunar infarcts. Arch Neurol 1990, 47:129.