(26) Metabolic Encephalopathies Flashcards
Signs and symptoms realatively unique to metabolic enchepalopaies (relative to this block)
seizures, sluggiish pupillary reflexes, altered respiration
type of metabolic encephalopathy most common in alcoholics
B1 deficiency (Wernike/Korsakoff Encephalopathy)
Triad of B1/Wernike Encephalopathy
opthaloparesis (horiz and vertical)
gait ataxia
confused state
pathology causing symptoms in B1/Wernike Encephalopathy
petechial hemorrhages and atrophy in thalamus, mammillary bodies, paeriaqueductal gray
treatment of B1/Wernike Encephalopathy
Thiamin BEFORE glc
***B1 needed for met of glc so if you give it after you will cause permanent brain damage
dry beriberi is assc with
lower limb paresthesias (axonal degeneration)
= another presentation of B1 deficiency
wet beriberi is assc with
high output cardiac failure
= another presentation of B1 deficiency
when lesions of the _____ tract are suspected, B12 deficieny shouldl always be ruled out
dorsal column or corticospinal
pathology of B12 def
demyelination of the dorsal columns, corticospinal tracts, optic and peripheral nerves
homocysteine levels (inc or dec) with B12 def
inc (it is a precursor)
decreased visual acutiy and central scotoma + pale optic disc
vit B complex deficiency
in a hypoglycemic state (symp or para) responses are heightened
symp (dialted pupils, brisk reflexes)
common clinical features of hypoxic encephalopathy
stupor or coma, seizures, myoclonus, amnesia after recovery
WHat areas of brain are most susceptible to hypoxic injury
watershead
hippocampus
deep folia of cerebellum
causes of hypoxic enceph
cardiac arrest
CO poisonin
high alt sickness
COPD with resultant CO2 narcosis
