Objective To explore the clinical characteristics and differential diagnosis of alcoholic withdrawl syn-drome and Wernicke's encephalopathy in order to reduce misdiagnosis rate. Methods A retrospective analysis of clinical data of 1 case of alcoholic withdrawl syndrome misdiagnosed as hepatic encephalopathy was made and the literature was reviewed. Results The patient was admitted for chief complain of convulsion and unconsciousness for 2 hours and had been diagnosed as alcoholic liver cirrhosis 2 years before admission to our hospital. After being admitted, the patient was diagnosed as having he-patic encephalopathy and treated with potassium magnesium aspirate, branched chain amino acid, etc. However, the patient de-veloped confusion, ophthalmalgia and convulsion at the first night. Then, MRI scanning showed typical findings of Wernicke's encephalopathy. Alcoholic withdrawal syndrome and Wernicke's encephalopathy were diagnosed. High doses of thiamine were given intravenously for 2 weeks. The patient recovered and was discharged. Conclusion Physicians should be aware of the possibility of alcoholic withdrawal syndrome and Wernicke's encephalopathy for all alcoholics, including patients with alcoholic cirrhosis. For all patients with suspected alcoholic withdrawal syndrome, thiamine supplementation should be given before ad-ministering glucose to avoid aggravation.%目的 探讨酒精戒断综合征并Wernicke脑病的临床特点和鉴别诊断要点,以减少误诊误治. 方法 对酒精戒断综合征误诊误治诱发Wernicke脑病1例的临床资料进行回顾性分析,并进行文献复习. 结果 本例以抽搐伴意识不清2h入院. 2年前确诊为酒精性肝硬化. 此次入院后按肝性脑病予门冬氨酸钾镁、支链氨基酸等治疗,当晚患者出现眼痛、意识不清、四肢抽搐,行MRI检查提示Wernicke脑病改变. 修正诊断为酒精戒断综合征、Wernicke脑病. 静脉予大剂量硫胺素治疗2周,病情好转出院. 结论 接诊既往有酗酒史的意识不清患者,应警惕酒精戒断综合征致Wernicke脑病的可能,及时予硫胺素治疗后方可应用葡萄糖注射液,以免加重病情.
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