Acute bilateral deafness and bilateral blindness in a patient with liver cirrhosis

Abstract

Background Wernicke encephalopathy (WE) is a devastating acute or subacute neurological disorder caused by thiamine deficiency. Wernicke encephalopathy is characterized by the triad of ocular signs, cerebellar dysfunction, and confusion. Visual loss and hearing loss are less common findings in WE. Here, we report a case of Wernicke encephalopathy in a nonalcoholic liver cirrhosis patient who present with acute bilateral deafness and bilateral blindness. Case presentation A 60-year-old Chinese man presented with a history of bilateral blindness and bilateral hypoacousia for 3 days. He had a history of liver cirrhosis, chronic hepatitis C virus infection and did not have a habit of alcohol consumption. Ophthalmologic and otologic examination showed no obvious abnormalities. MRI findings revealed symmetric FLAIR hyperintensities in the brain stem, medulla oblongata, bilateral dorsal thalamus, and periventricular region of the third ventricle. One day after hospitalization, the patient developed mild coma. Based on the laboratory and neuroimaging findings, we diagnosed the patient with Wernicke encephalopathy. He soon regained consciousness after administration of thiamine. Both visual acuity and hearing function improved gradually. Conclusions We suggest that Wernicke encephalopathy can present with bilateral blindness and bilateral deafness.