Wernicke encephalopathy: Difference between revisions

Latest revision as of 14:44, 16 October 2020

Background

Syndrome of cerebellar ataxia, ophthalmoplegia (usually bilateral CN VI palsies), and global confusion caused by vitamin B1 deficiency, usually in the context of chronic alcohol use, and often in the context of a combined Wernicke-Korsakoff syndrome

Pathophysiology

Thiamine (vitamin B1) deficiency, often associated with chronic alcohol abuse

Clinical Manifestations

Only a third present with the classic triad of cerebellar ataxia, ophthalmoplegia (usually bilateral CN VI palsies), and global confusion
Most are disoriented and inattentive
Ophthalmoplegia
- Horizontal nystagmus
- Lateral rectus (CN VI) palsy (usually bilateral)
- Conjugate gaze palsies
- Ptosis
Gait ataxia
Spares pupils unless severe
When there is additional amnesia, with or without confabulation, the syndrome is known as Wernicke-Korsakoff syndrome

Differential Diagnosis

Alcohol use disorder is most common
Other causes of malnutrition, including hyperemesis, starvation, dialysis, cancer, HIV/AIDS, or rarely gastric surgery

Management

Thamine 200 to 500mg IV/IM TID x3 days

Prognosis

Often leads to Korsakoff syndrome

@@ Line 1: / Line 1: @@
-== Definition ==
+==Background==
-* Syndrome of cerebellar ataxia, ophthalmoplegia (usually bilateral CN VI palsies), and global confusion caused by vitamin B1 deficiency
+*Syndrome of cerebellar ataxia, ophthalmoplegia (usually bilateral CN VI palsies), and global confusion caused by vitamin B1 deficiency, usually in the context of chronic alcohol use, and often in the context of a combined [[Wernicke-Korsakoff syndrome]]
-** Often has horizontal nystagmus
-* When there is additional amnesia, with or without confabulation, the syndrome is known as '''Wernicke-Korsakoff''' syndrome
+===Pathophysiology===
-== Etiology ==
-* Thiamine (vitamin B1) deficiency, often associated with chronic alcohol abuse
+*Thiamine (vitamin B1) deficiency, often associated with chronic alcohol abuse
+==Clinical Manifestations==
-== Differential Diagnosis ==
+*Only a third present with the classic triad of [[cerebellar ataxia]], [[ophthalmoplegia]] (usually bilateral CN VI palsies), and global confusion
-* Alcohol abuse is most common
+*Most are disoriented and inattentive
-* Other causes of malnutrition, including hyperemesis, starvation, dialysis, cancer, HIV/AIDS, or rarely gastric surgery
+*Ophthalmoplegia
+**Horizontal nystagmus
+**Lateral rectus (CN VI) palsy (usually bilateral)
+**Conjugate gaze palsies
+**Ptosis
+*[[Gait ataxia]]
+*Spares pupils unless severe
+*When there is additional [[amnesia]], with or without [[confabulation]], the syndrome is known as '''Wernicke-Korsakoff''' syndrome
+==Differential Diagnosis==
-== Clinical Manifestations ==
+*[[Alcohol use disorder]] is most common
-* Only a third present with the classic triad
+*Other causes of [[malnutrition]], including [[hyperemesis]], [[starvation]], [[dialysis]], [[cancer]], [[HIV|HIV/AIDS]], or rarely gastric surgery
-* Most are disoriented and inattentive
-* Ophthalmoplegia
-** Horizontal nystagmus
-** Lateral rectus (CN VI) palsy (usually bilateral)
-** Conjugate gaze palsies
-** Ptosis
-* Gait ataxia
-* Spares pupils unless severe
-== Management ==
+==Management==
-* Thamine 200-500mg IV/IM TID x3 days
+*[[Thamine]] 200 to 500mg IV/IM TID x3 days
-== Prognosis ==
+==Prognosis==
-* Often leads to Korsakoff syndrome
+*Often leads to Korsakoff syndrome
 [[Category:Neurology]]