Postseizure aphasia in Wernicke’s encephalopathy: a case report and review of literature

Figures & data

Table 1 Medication administration and CIWA

Day	Medication	CIWA score
1	Phenytoin 885 mg IV, lorazepam 4 mg, diazepam 2 mg, thiamine 100 mg PO
2	Alcohol withdrawal protocol, lacosamide IV, thiamine 100 PO, levetiracetam 750 mg IV, levetiracetam 750 mg PO, diazepam 1 mg IV	17, 3, 3, 16, 5, 4, 3
3	Thiamine 500 mg q8h IV, levetiracetam 750 mg BID, lorazepam 2 mg PO, haloperidol 2 mg IV	3
4	Thiamine 500 mg q8h IV, levetiracetam 750 mg BID, aripiprazole 2.5 mg PO	3, 2
5	Thiamine 500 mg q8h IV, levetiracetam 750 mg BID, aripiprazole 2.5 mg PO, acamprosate	0, 0, 0

Abbreviations: BID, twice a day; CIWA, Clinical Institute Withdrawal Assessment for alcohol; IV, intravenous; PO, per os; q8h, every 8 hours.

Figure 1 Continuous 17-hour video EEG monitoring.

Notes: The EEG was collected digitally and stored in a computer that has seizure detection as well as spike detection software. The patient can activate a push-button event as well as the nurse to indicate if a clinical event has occurred. With the patient awake, the background showed no clear dominant occipital rhythm over the left hemisphere. There was low voltage beta activity recorded diffusely. There is irregular polymorphic Δ/θ activity recorded at 3–5 Hz maximal over the left temporoparietal region.
Abbreviation: EEG, electroencephalogram.

Figure 2 Current admission shows less pronounced left mesial temporal abnormality.

Figure 3 Admission 9 months prior showing nonspecific FLAIR abnormality in the left mesial temporal lobe.