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BMJ Case Rep ; 17(2)2024 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-38417935

RESUMEN

We report a child with steroid-dependent nephrotic syndrome presenting with excessive irritability, double vision and inability to walk for 5 days. On examination, the child was irritable with Glasgow coma sccale (GCS of 12/15, had bilateral convergent squint (R>L), vertical nystagmus, ataxia without any focal neurological deficits and normal fundus. MRI brain with venogram showed bilateral symmetric FLAIR hyperintensity in the medial thalamus and periaqueductal grey matter showing diffuse restriction with normal venogram. A possibility of Wernicke encephalopathy (WE) was considered and the child was started on thiamine supplementation, following which he had significant improvement in his symptoms. His irritability reduced with significant improvement in the range of eye movements and vertical nystagmus. At 3-month follow-up, the child is asymptomatic with normal gait. Although WE is uncommon in children with nephrotic syndrome, the possibility has to be kept in mind when a child presents with atypical neurological symptoms.


Asunto(s)
Síndrome de Korsakoff , Síndrome Nefrótico , Nistagmo Patológico , Encefalopatía de Wernicke , Masculino , Niño , Humanos , Síndrome Nefrótico/complicaciones , Síndrome Nefrótico/tratamiento farmacológico , Encefalopatía de Wernicke/diagnóstico , Tiamina/uso terapéutico , Nistagmo Patológico/etiología , Movimientos Oculares
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