Wernicke encephalopathy: Difference between revisions
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* Other causes of malnutrition, including hyperemesis, starvation, dialysis, cancer, HIV/AIDS, or rarely gastric surgery |
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* Only a third present with the classic triad |
* Only a third present with the classic triad |
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Revision as of 09:55, 2 August 2020
Definition
- Syndrome of cerebellar ataxia, ophthalmoplegia (usually bilateral CN VI palsies), and global confusion caused by vitamin B1 deficiency
- Often has horizontal nystagmus
- When there is additional amnesia, with or without confabulation, the syndrome is known as Wernicke-Korsakoff syndrome
Etiology
- Thiamine (vitamin B1) deficiency, often associated with chronic alcohol abuse
Differential Diagnosis
- Alcohol abuse is most common
- Other causes of malnutrition, including hyperemesis, starvation, dialysis, cancer, HIV/AIDS, or rarely gastric surgery
Clinical Manifestations
- Only a third present with the classic triad
- 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
- Thamine 200-500mg IV/IM TID x3 days
Prognosis
- Often leads to Korsakoff syndrome
