Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Wernicke's encephalopathy is an acute neurological disorder characterized by mental confusion, oculomotor dysfunction, and ataxia. It has been reported in individuals with alcohol dependence, hyperemesis gravidarum, and prolonged parenteral nutrition without vitamin supplementation. Here we present the case of a 13-year-old male patient with neuroblastoma and a history of poor oral intake and nausea for 3 months. After admission, he showed gait disturbances, nystagmus, and excessive dizziness; his mental state, however, indicated he was alert, which did not fit the classical triad of Wernicke's encephalopathy. A diagnosis of Wernicke's encephalopathy was made only after brain magnetic resonance imaging and serum thiamine level analyses were performed. The patient's symptoms remained after 5 days of treatment with 100-mg thiamine once daily; thus, we increased the dosage to 500 mg 3 times daily, 1,500 mg per day. His symptoms then improved after 20 days of replacement therapy. This case report describes a pediatric patient who was promptly diagnosed with Wernicke's encephalopathy, despite only 2 suspicious symptoms, and who completely recovered after high doses of thiamine were given intravenously.
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PMID:Wernicke's encephalopathy in a child with high dose thiamine therapy. 2555 Jul 5

Diagnosis of combined peripheral and central vestibulopathy remains a challenge since the findings from peripheral vestibular involvements may overshadow those from central vestibular disorders or vice versa. The aim of this study was to enhance detection of these intriguing disorders by characterizing the clinical features and underlying etiologies. We had recruited 55 patients with combined peripheral and central vestibulopathy at the Dizziness Clinic of Seoul National University Bundang Hospital from 2003 to 2013. Peripheral vestibular involvement was determined by decreased caloric responses in either ear, and central vestibulopathy was diagnosed with obvious central vestibular signs or the lesions documented on MRIs to involve the central vestibular structures. Combined peripheral and central vestibulopathy could be classified into four types according to the patterns of vestibular presentation. Infarctions were the most common cause of acute unilateral cases while cerebellopontine angle tumors were mostly found in chronic unilateral ones. Wernicke encephalopathy and degenerative disorders were common in acute and chronic bilateral disorders. Twenty five (45.5%) patients showed only vestibular findings with or without auditory involvements, but association with gaze-evoked nystagmus, impaired smooth pursuit or central types of head shaking nystagmus indicated a central vestibular involvement in most of them (23/25, 92.0%). Given the requirements for urgent treatments and potentially grave prognosis of combined vestibulopathy, central signs should be sought even in patients with clinical or laboratory features of peripheral vestibulopathy. Scrutinized bedside evaluation, however, secured the diagnosis in almost all the patients with combined vestibulopathy.
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PMID:Chasing dizzy chimera: Diagnosis of combined peripheral and central vestibulopathy. 2787 53

We described the case of a young man with morbid obesity who underwent bariatric surgery who experiences different complications. After the discharge the patient starts to complain about nausea, dizziness, and visual impairment. After a first access to an emergency department, with a diagnosis of labyrinthopathy, the patient gets worse. He then has been hospitalized and a wernicke's encephalopathy was diagnosed. During the hospitalization other comploication of low thiamine appeared such as wet beriberi. The clinical picture was also complicated with the refeeding syndrome. Wernicke's encephalopathy, wet beriberi, and refeeding syndrome are life-threatening conditions that can be prevented and treated. Both physicians and patients must be warned about these potential risks in order to put in act a prompt treatment.
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PMID:Wernicke's encephalopathy, refeeding syndrome and wet beriberi after laparoscopic sleeve gastrectomy: the importance of thiamine evaluation. 3204 91