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Washington University Experience | METABOLIC | Wernicke Encephalopathy | 9A0 Case 9 History
Case 9 History ---- The decedent was a 50 year old woman with a history of chronic alcohol abuse, whose family said that they had not seen her eat anything for two months after the Thanksgiving holiday until the end of the year. She suffered complications of alcoholism including fatty metamorphosis of the liver, liver necrosis as well as confusion and disorientation, thought to reflect Wernicke encephalopathy. Near the end of her life she had at least one fall striking her head. Finally, she developed a fulminant pneumonitis and died.
The neuropathologic findings at autopsy included small mammillary bodies which were externally unremarkable although discolored and friable on cut section. According to report, the mamillary bodies showed striking vascularity and demyelination with spongy myelin and preservation of neurons with hemosiderin containing macrophages. Increased vascularity and cellularity in the periaqueductal area of the mesencephalon were also reported. There was no evidence of cerebellar folial atrophy. A diagnosis of Wernicke encephalopathy was made.
