CAJ | 학술논문

目的：探讨非酒精性Wernicke脑病（Wernicke’s encephalopathy ，WE）的病因、临床表现、影像学检查及治疗。方法回顾性分析我院住院的18例非酒精性W E患者的临床资料。结果各种原因所引起的体内维生素B1缺乏均可导致非酒精性WE的发生；临床可表现为精神及意识障碍、眼外肌麻痹和共济失调三联征，但典型的 WE 三联征仅有3例（16.7％），其余往往以其中1种或2种表现为主，精神及意识障碍最常见（77.8％），而眼外肌麻痹（33.3％）和共济失调（27.8％）相对较少；影像学检查以头颅M RI为首选，病灶多对称性分布于脑中线结构附近，最常见累及部位是丘脑内侧、第三脑室周围（61.1％）、中脑导水管周围区域（55.6％）、乳头体（38.9％）；18例患者经及时的大剂量补充维生素B1，临床表现均有不同程度的改善。结论各种引起维生素B1缺乏的因素均可为W E的病因，识别不典型的临床表现及特征性头颅M RI改变，对WE早期诊断及治疗具有重要意义。
목적：탐토비주정성Wernicke뇌병（Wernicke’s encephalopathy ，WE）적병인、림상표현、영상학검사급치료。방법회고성분석아원주원적18례비주정성W E환자적림상자료。결과각충원인소인기적체내유생소B1결핍균가도치비주정성WE적발생；림상가표현위정신급의식장애、안외기마비화공제실조삼련정，단전형적 WE 삼련정부유3례（16.7％），기여왕왕이기중1충혹2충표현위주，정신급의식장애최상견（77.8％），이안외기마비（33.3％）화공제실조（27.8％）상대교소；영상학검사이두로M RI위수선，병조다대칭성분포우뇌중선결구부근，최상견루급부위시구뇌내측、제삼뇌실주위（61.1％）、중뇌도수관주위구역（55.6％）、유두체（38.9％）；18례환자경급시적대제량보충유생소B1，림상표현균유불동정도적개선。결론각충인기유생소B1결핍적인소균가위W E적병인，식별불전형적림상표현급특정성두로M RI개변，대WE조기진단급치료구유중요의의。
Objective To investigate the etiology ,clinical manifestations ,imaging and treatment of patients with nonalco-holic Wernicke’s encephalopathy (WE).Methods Clinical data of 18 hospitalized patients with nonalcoholic WE were retro-spectively analyzed. Results Vitamin B1 deficiency caused by various kinds of reasons could lead to the occurrence of non-alco-holic WE. The clinical manifestations of patients were the mental and conscious disturbance ,extraocular muscle paralysis and ataxia. But only three cases (16.7% ) were the typical triad and the rest were dominated by one or two forms. The most com-mon clinical manifestations were mental and consciousness disorders (77.8% ) ,while the extraocular muscle paralysis (33.3% ) and ataxia (27.8% ) were relatively less. MRI showed that the brain lesions distributed symmetrically in the midline of brain such as medial hypothalamus and third periventricular (61.1% ) , periaqueductal region (55.6% ) and mammillary bodies (38.9% ). All patients were improved after supplying large doses of vitamin B 1. Conclusion Vitamin B1 deficiency caused by various kinds of factors can lead to WE. It’s of great significance to identify atypical clinical manifestations and characteristic changes of MRI in brain ,which can help for early diagnosis and treatment.