Photophobia and bilateral pulvinar involvement in non-alcoholic Wernicke’s encephalopathy
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Photophobia is a subjective discomfort to light, varying from mild to intolerable pain, which can be associated with disorders of the anterior eye segment, or intracranial diseases . Although the exact pathophysiology remains obscure, an interaction between the trigeminal nociceptive pathway and the visual system at various brain and ocular levels is accepted [1, 2]. A possible involvement of pulvinar has been recently considered, since it receives both second-order trigeminal neurons projections  and direct retinal fibers belonging to the non-visual forming pathway (NVFP) [4, 5]. Wernicke’s encephalopathy (WE) is an acute neurological disorder due to thiamine deficiency, usually involving specific brain areas, such as thalamus and periaqueductal region, also accounted in the pathway of photophobia. Photophobia, however, has never been reported as presenting symptom in WE.
Here we report two patients with photophobia as manifesting symptom of non-alcoholic WE, who,...
KeywordsNeuro-ophtalmology Non-alcoholic Wernicke’s encephalopathy Photophobia Brain MRI
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