HYBRID EVENT: You can participate in person at Boston, Massachusetts, USA or Virtually from your home or work.

8th Edition of International Conference on Neurology and Brain Disorders

October 19-21, 2023

October 19 -21, 2023 | Boston, Massachusetts, USA
INBC 2022

Mohammad Abu-Abaa

Speaker at Neurology and Brain Disorders 2022 - Mohammad Abu-Abaa
Capital Health Internal Medicine Residency, United States
Title : Seizure As The Main Manifestation of Non Alcoholic Wernicke’s Encephalopathy but Without Cortical Involvement


This is a case report of a 45 years old female patient with a past medical history of depression and poor oral intake presented for a single episode of unwitnessed seizure and 3 days of unsteady gait and vertigo. Then she had two episodes of seizure focal and then generalized tonic. Physical exam was remarkable for lethargy, bilateral gaze induced horizontal nystagmus with rotational component and change in direction. MRI brain with contrast showed non enhancing bilateral symmetrical FLAIR hyperintensities in medial thalami and tectum. Vitamin B1 level was found to be low. Lumbar puncture was unyielding. She was loaded with high dose thiamine replacement. After a few days, a neurological exam revealed improvement with unilateral nystagmus with less lethargy. Valproate that was started initially was eventually discontinued during follow-up after resolution of neurological deficits. Interestingly, a baseline echocardiography showed heart failure with reduced ejection fraction at 40% with clinical euvolemia. It was believed to be secondary to Beri Beri.

This case serves to remind us that seizure can be the main manifestation of Wernicke’s encephalopathy (WE) even without cortical involvement. It also shows that early thiamine replacement can result in significant neurological improvement. We believe this is a good case to report as seizure as initially presentation of WE was reported only in 4 cases in English literature. In this case report, we aim to review what the English literature has to answer the questions of differences between alcoholic and non alcoholic WE, risk factors of non alcoholic WE, typical and atypical MRI findings, and prevalence of seizure and cortical lesion in WE.

What will the audience learn from the presentation ?

-    Seizure is a rare but possible initial presentation of WE

-    Differences between alcoholic and non alcoholic WE

-    Risk factors for non alcoholic WE

-    Typical and atypical MRI findings in WE


Dr. Abu-Abaa graduated from the University Of Basrah College Of Medicine in Iraq in the top 5% of his class. Following graduation, he completed a Transitional Year of training followed by two years of Internal Medicine and six months of neurology training experiences. He is currently doing Internal Medicine training at Capital Health, Trenton, NJ.