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May 6, 1939

IS NUTRITIONAL DEFICIENCY THE BASIS OF WERNICKE'S DISEASE?REPORT OF CASE

Author Affiliations

Fellow in Neurology, the Mayo Foundation; ROCHESTER, MINN.

From the Section on Neurology, the Mayo Clinic.

JAMA. 1939;112(18):1794-1796. doi:10.1001/jama.1939.02800180018006
Abstract

In 1881 Wernicke1 described under the formidable title "encephalitis haemorrhagica superior" a disease affecting the nuclei of the nerves to the eye muscles which leads to death in a few days. The clinical signs consist of paralysis of the eye muscles, a reeling gait and disturbances of consciousness—a terminal somnolence which may or may not be preceded by a period of excitement. This syndrome has been found occasionally in association with Korsakoff's psychosis (Bonhoeffer1) and with polyneuritis. Tachycardia (unassociated with fever) is common, and disturbances of breathing are sometimes observed. There is an occasional report of recovery.

Perhaps the most typical anatomic feature of the disease2 is the distribution of the lesions, which are largely limited to the gray structures near the third and fourth ventricles and the aqueduct. Sections of the brain reveal, even macroscopically, the presence of hemorrhagic areas in the mammillary bodies, posterior corpora

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