{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:42:13Z","timestamp":1786653733419,"version":"build-2736575974"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Neuromyelitis optica spectrum disorders (NMOSD) encompass a spectrum of immunomediated diseases presenting with diverse syndromes. Conversely, Wernicke\u2019s encephalopathy denotes an acute neurological condition stemming from severe thiamine (Vitamin B1) deficiency. We report a unique case of NMOSD manifesting with clinical and radiological characteristics resembling Wernicke\u2019s encephalopathy, exhibiting unresponsiveness to thiamine therapy and subsequent clinical deterioration. Our report highlights an atypical and rare presentation of NMOSD, initially confounded by changes on magnetic resonance imaging attributed to thiamine deficiency, delaying appropriate management during the early hospitalization period. While brain abnormalities are frequently documented in NMOSD, the occurrence of vertigo as an inaugural symptom is seldom reported. The patient demonstrated recovery following aggressive therapeutic interventions, including pulse steroids, plasma exchange, and rituximab therapy. Our case underscores the importance of considering NMOSD in patients displaying clinical and radiological features reminiscent of Wernicke\u2019s encephalopathy, particularly when thiamine replacement fails to elicit a response. Clinicians must recognize this unusual presentation of NMOSD promptly and initiate aggressive therapeutic measures. Early diagnosis assumes critical significance to promptly commence aggressive immunomodulatory therapy.<\/jats:p>","DOI":"10.4103\/ant.ant_112_0071","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T13:02:05Z","timestamp":1743339725000},"page":"43-47","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Neuromyelitis Optica Spectrum Disorders Mimicking Wernicke\u2019s Encephalopathy: A Difficult Differential Diagnosis"],"prefix":"10.4103","volume":"34","author":[{"given":"Hussein","family":"Algahtani","sequence":"first","affiliation":[{"name":"Neurology Section, Department of Medicine, Aseer Central Hospital, Abha, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bader","family":"Shirah","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi 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Taiwanica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ANT.ANT_112_0071","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:41:38Z","timestamp":1786650098000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ANT.ANT_112_0071"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ant.ant_112_0071","relation":{},"ISSN":["1028-768X"],"issn-type":[{"value":"1028-768X","type":"print"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2023-08-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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