{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T07:32:16Z","timestamp":1767771136299,"version":"3.40.4"},"reference-count":21,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,8,8]]},"abstract":"<jats:p>Progressive supranuclear palsy (PSP) may be a risk factor for thiamine deficiency. The classic symptoms of PSP (postural instability, supranuclear vertical gaze palsy and dementia) overlap with the clinical triad of Wernicke\u2019s encephalopathy (cognitive impairment, gait problems and ocular abnormality). Therefore, superimposed thiamine deficiency in patients with PSP may aggravate the pre-existing symptoms of PSP. Here, we are reporting a 64-year-old woman having supranuclear ocular palsy, gait instability and dementia for the past 2\u20133 years. The patient fulfilled the diagnostic criteria of PSP. In parallel, she fulfilled the Caine\u2019s criteria of Wernicke\u2019s encephalopathy. Her serum thiamine level was low. Supplementation of thiamine led to marked improvement in the symptoms which had been present for many years. These symptoms were originally presumed to be due to PSP. This case highlights the needs to identify superimposed thiamine deficiency in patients with PSP.<\/jats:p>","DOI":"10.1136\/bcr-2018-226170","type":"journal-article","created":{"date-parts":[[2018,8,21]],"date-time":"2018-08-21T04:17:17Z","timestamp":1534825037000},"page":"bcr-2018-226170","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Progressive supranuclear palsy responding to intravenous thiamine: superimposed Wernicke\u2019s encephalopathy?"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7322-904X","authenticated-orcid":false,"given":"Sanjay","family":"Prakash","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hemant","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,8,20]]},"reference":[{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1381736"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.2","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s11910-018-0819-5","article-title":"Progressive supranuclear palsy: an update","volume":"18","author":"Armstrong","year":"2018","journal-title":"Curr Neurol Neurosci Rep"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70042-0"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.4","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awm032"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.5","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.47.1.1"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.6","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1002\/mds.26987","article-title":"Clinical diagnosis of progressive supranuclear palsy: The movement disorder society criteria","volume":"32","author":"H\u00f6glinger","year":"2017","journal-title":"Mov Disord"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.7","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.62.1.51"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.8","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70104-7"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.9","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1007\/s00234-017-1812-4","article-title":"Beyond the midbrain atrophy: wide spectrum of structural MRI finding in cases of pathologically proven progressive supranuclear palsy","volume":"59","author":"Sakurai","year":"2017","journal-title":"Neuroradiology"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.10","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1111\/head.12838","article-title":"Chronic migraine responding to intravenous thiamine: a report of two cases","volume":"56","author":"Prakash","year":"2016","journal-title":"Headache"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.11","doi-asserted-by":"crossref","first-page":"e00616","DOI":"10.1002\/brb3.616","article-title":"Weight loss in the early stage of progressive supranuclear palsy","volume":"7","author":"Tsuge","year":"2017","journal-title":"Brain Behav"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.12","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1001\/archopht.1954.00920040206007","article-title":"Ocular signs of wernicke\u2019s disease","volume":"51","author":"COGAN","year":"1954","journal-title":"AMA Arch Ophthalmol"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2012.08.014"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.14","doi-asserted-by":"publisher","DOI":"10.1089\/acm.2014.0353"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.15","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1007\/s12264-016-0067-0","article-title":"Long-term cognitive improvement after benfotiamine administration in patients with alzheimer\u2019s disease","volume":"32","author":"Pan","year":"2016","journal-title":"Neurosci Bull"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.16","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3966"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.17","doi-asserted-by":"crossref","first-page":"751","DOI":"10.17219\/acem\/63091","article-title":"Role of thiamine in huntington\u2019s disease pathogenesis: In vitro studies","volume":"26","author":"Gruber-Bzura","year":"2017","journal-title":"Adv Clin Exp Med"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2004.06.013"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.19","doi-asserted-by":"publisher","DOI":"10.1007\/s11065-012-9203-4"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.20","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1590\/S0004-282X2010000600020","article-title":"Progressive supranuclear palsy: new concepts","volume":"68","author":"Barsottini","year":"2010","journal-title":"Arq Neuropsiquiatr"},{"key":"2025042705591817000_2018.aug20_1.bcr-2018-226170.21","doi-asserted-by":"crossref","first-page":"372","DOI":"10.3341\/kjo.2017.0014","article-title":"Wernicke\u2019s encephalopathy presenting with bilateral complete horizontal and downward gaze palsy in a malnourished patient","volume":"31","author":"Kim","year":"2017","journal-title":"Korean J Ophthalmol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-226170","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T12:59:28Z","timestamp":1745758768000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-226170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,20]]},"references-count":21,"alternative-id":["10.1136\/bcr-2018-226170"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-226170","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,8,20]]}}}