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Hypothermia, Wernicke encephalopathy and multiple sclerosis

Neurological exacerbation observed in MS patients is usually related to a demyelinating process. We report two patients where hypothermia (32.4°C and 32.5°C) and neurological exacerbation were probably due to a Wernicke encephalopathy (WE). The clinical features and the rapid efficiency of parenteral thiamine were suggestive of WE. Hypothermia is an exceptional symptom observed in MS and has been considered as resulting from hypothalamic demyelination; these two cases showed that WE which is another cause of reversible hypothermia, can be associated with MS.