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Vestibular responses in wernicke's encephalopathy
Author(s) -
Furman Joseph M. R.,
Becker James T.
Publication year - 1989
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410260513
Subject(s) - vestibulo–ocular reflex , reflex , vestibular system , vestibular nuclei , nystagmus , medicine , caloric theory , righting reflex , audiology , eye movement , anesthesia , ophthalmology
Abstract Two patients with Wernicke's encephalopathy were evaluated with quantitative vestibulo‐ocular reflex and ocular motor testing. Vestibulo‐ocular reflex testing included caloric irrigation, earth vertical axis rotational sinusoids, and rotational impulses. Both patients demonstrated hypoactive vestibular responses to both caloric and rotational stimuli at the time of presentation. One patient had upbeating nystagmus that diminished with upgaze, downgaze, or convergence. Following treatment with thiamine, both patients' vestibular responses improved but remained abnormal, with a short vestibulo‐ocular reflex time constant and increased low‐frequency rotational phase lead. Impairment of the velocity storage element attributable to damage to the vestibular nucleus and nucleus prepositus hypoglossi may account for this permanent effect on the vestibulo‐ocular reflex.