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December 1946

HISTOPATHOLOGY OF POLIOENCEPHALITIS HEMORRHAGICA SUPERIOR (WERNICKE'S DISEASE)

Author Affiliations

CHICAGO

From the Department of Anatomy of the University of Southern California, and the Neurological Service of the Presbyterian Hospital.

Arch NeurPsych. 1946;56(6):609-630. doi:10.1001/archneurpsyc.1946.02300230003001
Abstract

THE CONDITION named polioencephalitis hemorrhagica superior by Wernicke1 was considered by him to be largely, yet not entirely, due to alcohol poisoning. The symptoms are palsies of the ocular muscles, which finally lead to complete paralysis, reeling gait, vertigo, headache, nystagmus, optic neuritis, photophobia and disturbances of consciousness. The last-mentioned symptom may be characterized by drowsiness either from the onset or as a terminal state. External ophthalmoplegia may occur in varying degrees and combinations. Certain ocular muscles, such as the sphincter of the iris and the levator palpebrae, are usually unaffected. The pathologic process involves the origin of the upper cranial nerves but may extend to include the lower ones (polioencephalitis superior and inferior), resulting in bulbar paralysis. The disease follows an acute or a subacute course and usually ends in death in eight to fourteen days, but a more protracted course with ultimate recovery may occur. All 3

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