WERNICKE'S  ENCEPHALOPATHY

 

Etiology:

  1. Vitamin B1 (Thiamine) deficiency. Commonly in alcoholics but can  occur in  other malnourished people (e.g.acute Beri-Beri), pt treated with TPN and inadequate vit. B1 supply.

S & S:

  1. It is an acute episode
     
  2. Classically  triad of  Ataxia,  AMS, Sixth nerve palsy and/or Nystagmus, but these symptoms may  be variably present and hard to diagnose when high ETOH level. Hypothermia, coma, and  BP can be present as well.

DX:

  1. Physical exam and history.

Treatment:

  1. B1 100mg IM STAT and  for few days QD. Occular signs are the first to resolve  in a few hrs while coma may take longer  (hrs to days). Memory  may be permanently affected and pt is  unable to recall long term memory and  develop chronic confabulation - Korsakoff's  syndrome.

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