29. Wernicke-Korsakoff syndrome

Question 1

Define Wernicke-Korsakoff syndrome

Answer 1

Brain damage caused by Thiamine (vit B12) deficiency

Question 2

Triad of symptoms in Wernicke encephalopathy

Answer 2

1. Oculomotor dysfunction
2. Trunk and gait ataxia
3. Encephalopathy

Question 2

Which two diseases are combined in Wernicke-Korsakoff syndrome?

Answer 2

Wernicke’s encephalopathy + Korsakoff syndrome

Question 2

Etiology of Wernicke-Korsakoff syndrome

Answer 2

Secondary to chronic alcoholism or malnutrition

Question 3

Importance of thiamine (vitamin B1)

Answer 3

Derivatives are involved in catabolism of sugars and AA. Brain and CV system vulnerable to its deficiency.

Question 4

Food rich in thiamine

Answer 4

Rice, pork, peas, spinach

Question 5

Oculomotor dysfunction in Wernicke encephalopathy

Answer 5

Horizontal and vertical nystagmus, diplopia, opthalmoplegia, ocular nerve palsy, gaze palsy, anisocoria, dysconjugated eye movements, ptosis

Question 6

Encephalopathy in Wernicke encephalopathy

Answer 6

Confusion, disorientation, psychosis, delirium

Question 7

Anatomy of Werincke encephalopathy

Answer 7

Bilateral lesions around 3rd, 4th ventricle and cerebral aqueduct

Question 8

Diagnosis of Wernicke-Korsakoff syndrome

Answer 8

• Clinical
• Labs (albumin, malnutrition)
• Decreased thiamine transketolase activity
• CT/MRI to rule out other causes

Question 8

Complication of untreated Werincke encephalopathy

Answer 8

Fatal lactic acidosis

Question 8

Symptoms of Korsakoff syndrome

Answer 8

• anterograde amnesia
• short-term memery loss
• confabulations
• disorientation in time and space

Question 8

Disease progression of Werincke-Korsakoff syndrome

Answer 8

Wernicke encephalopathy first, then korsakoff syndrome. Symptoms of Werincke decrease as KS develops

Question 8

Treatment of Wernicke-Korsakoff syndrome

Answer 8

Thiamine replacement therapy (IV)