Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0029089 (ophthalmoplegia)
 3,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Author has noticed bilateral ophthalmoplegia in consequence of B1 avitaminosis due to alcoholism. Recognition of the cerebral beriberi with ophthalmoplegia as a leading symptom (Wernicke's encephalopathy) is easy. The importance of the diagnosis is that this life threatening condition can be abolished promptly by the administration of Vitamin B1. On the basis of the frequent occurrence of alcoholism it seems likely, that several similar beriberi cases could be found nowadays.
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PMID:[Cerebral beriberi with ophthalmoplegia as the leading symptom in an alcoholic patient]. 195 87

Beri-Beri is caused by vitamin B1 (thiamine) deficiency. Thiamine is essential for carbohydrate metabolism and the generation of energy. Depending on age and calorie intake, 1-1.5mg/day are required with a 50% increase during pregnancy and lactation. Fever and increased muscular activity will also increase thiamine requirements (storage in muscles is limited, and reserves are quickly depleted). The sources of thiamine are meat, the outer layer of cereal grains and pulses, nuts, and leafy vegetables. The vitamin is lost during milling and processing and during excessive cooking. Beri-beri takes 2 forms: wet beri-beri which has a high output biventricular failure with edema associated with profound peripheral vasodilation and tachycardia (this also occurs in an acute fulminating form known as shoshin beri-beri) and dry beri-beri with symptoms of peripheral neuropathy with taxia, weakness, paraesthesia, and patchy sensory loss with areflexia. In this form, foot and/or wrist drop may occur. Thiamine deficiency can also produce Wernicke-Korsakoff psychosis characterized by vomiting, horizontal nystagmus, ophthalmoplegia, memory loss, and confabulation. Wet beri-beri is a medical emergency treated by intravenous administration of thiamine for several days. 38 patients (27 men and 11 women) were identified with beri-beri in urban Banjul in the Gambia. 14 had wet beri-beri, 11 a mixed presentation, and 13 dry beri-beri. Most of the patients were disabled for many months. Risk factors were pregnancy, alcohol consumption, fever, exercise, diabetes, and dysentery. 4 of the patients died (2 were in the last trimester of pregnancy). The staple diet in urban areas of the Gambia is imported, polished white rice in a groundnut- or oil-based sauce with fish and vegetables such as peppers, onions, and tomatoes. Meat is too expensive for the urban poor, and fruit and vegetable consumption is highly seasonal and income-dependent. There is little chance that this diet will be changed for the 46% of the population who live in urban areas. It is likely that a substantial proportion of the population has subclinical thiamine deficiency and are at risk of beri-beri. Since thiamine added to imported rice will be destroyed by traditional means of cooking, adding the vitamin to wheat flour may be an appropriate public health measure.
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PMID:Beri-beri: "Endemic amongst urban Gambians". 1231 72

A 55-years-old man with a history of alcoholism, hypertension and obesity was diagnosed of epidermoid carcinoma of the middle third portion of the esophagus. He was treated with two cycles of cytostatics with cisplatin and 5-fluorouracil. Due to his poor general health an inability to swallow solids and liquids, he received parenteral nutrition for 20 days using a commercial formula lacking in vitamins and minerals. During distal esophagectomy we observed a tendency to hypotension and severe metabolic acidosis that was unexplained by the hemodynamic profile and that persisted throughout the first 24 hours after surgery. Once these complications were corrected, he was weaned from mechanical ventilation and the following neurological signs were observed: temporal and spacial disorientation, aphasia, ophthalmoplegia with divergent strabismus and later conduction aphasia, amnesia and confabulation. Circulation was hyperdynamic, requiring inotropics and vasoconstrictors. Korsakoff syndrome secondary to Wernicke's encephalopathy was diagnosed, and the response to thiamine treatment was favorable. Beriberi can be found in hospitalized patients and the anesthesiologist may be involved in their perioperative care. Symptoms resolve easily with vitamin B1 treatment, which is ideally provided along with other hydrosoluble vitamins. Treatment should be prompt because delay leads to greater morbiomortality.
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PMID:[Beriberi after esophagectomy]. 1267 75

A 42-year-old man presented in the Department of Ophthalmology of Holstebro Central Hospital with a history of alcohol abuse, vomiting and weight loss. The initial symptoms of beriberi were stiffness of the legs and a picture of Wernicke's syndrome. He had bilateral loss of horizontal eccentric gaze holding and upbeat nystagmus, and visual acuity was reduced to counting fingers. Visual acuity was tested in the down-gaze position and increased to 0.3 because of reduced nystagmus. The patient's oculomotor function improved dramatically after treatment with thiamine. Wernicke's encephalopathy and beriberi are discussed, highlighting that nystagmus may be the single ocular symptom. It should be considered in the differential diagnosis of bilateral ophthalmoplegia even in the absence of altered mental status.
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PMID:[Reduced vision in Wernicke's syndrome with symptoms of nystagmus]. 1658 77

The clinical presentation of beriberi can be quite varied. In the extreme form, profound cardiovascular involvement leads to circulatory collapse and death. This case report is of a 72 year-old male who was admitted to the Neurology inpatient ward with progressive bilateral lower extremity weakness and parasthesia. He subsequently developed pulmonary edema and high output cardiac failure requiring intubation and blood pressure support. With the constellation of peripheral neuropathy, encephalopathy, ophthalmoplegia, unexplained heart failure, and lactic acidosis, thiamine deficiency was suspected. He was empirically initiated on thiamine replacement therapy and his thiamine level pre-therapy was found to be 23 nmol/L (Normal: 80-150 nmol/L), consistent with the diagnosis of beriberi. Cardiovascular magnetic resonance (CMR) showed severe left ventricular systolic dysfunction, markedly increased myocardial T2, and minimal late gadolinium enhancement (LGE). After 5 days of daily 100 mg IV thiamine and supportive care, the hypotension resolved and the patient was extubated and was released from the hospital 3 weeks later. Our case shows via CMR profound myocardial edema associated with wet beriberi.
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PMID:Cardiovascular magnetic resonance in wet beriberi. 2183 1

The incidence of neurologic complications from bariatric surgery is rising with the prevalence of obesity and the increasing number of bariatric surgeries. We report a 25-year-old woman who developed subacute progressive weakness and areflexia followed by confusion, ophthalmoplegia, and nystagmus following bariatric surgery. While the differential of generalized weakness with altered mental status is broad, vitamin deficiency should be routinely suspected after bariatric surgery to prevent permanent neurological injury. Multifocal neurological dysfunction in our patient represented beriberi and Wernicke's encephalopathy related to vitamin B1 deficiency.
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PMID:Dry Beriberi and Wernicke's encephalopathy following gastric lap band surgery. 2252 60

An otherwise healthy 30-year-old male acquired gastrointestinal beriberi and subsequent Wernicke's encephalopathy after 1 session of heavy drinking. Nausea, vomiting, and anorexia relentlessly progressed. The patient developed external ophthalmoplegia after 2 months. Intravenous 1,000 mg thiamine reversed both neurologic and gastrointestinal symptoms within hours. It is hard to diagnose gastrointestinal beriberi since the symptoms are nonspecific. The patient underwent 11 emergency room visits, 3 hospital admissions, and laparoscopic cystectomy within 2 months, but the gastrointestinal symptoms continued to progress. Two months after the onset of gastrointestinal symptoms, external ophthalmoplegia appeared, and, therefore, intravenous thiamine was given. The simultaneous resolution of the debilitating gastrointestinal symptoms and external ophthalmoplegia was unique. Thiamine deficiency remains underdiagnosed and should be considered in patients who develop unexplained gastroparesis or autonomic nervous failure of the digestive system, even in the nonalcoholic population.
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PMID:Gastrointestinal Beriberi and Wernicke's Encephalopathy Triggered by One Session of Heavy Drinking. 3154 93