Alcoholism

Question 1

What is Wernicke’s encephalopathy?

Answer 1

Neuropsychiatric disorder caused by thiamine deficiency which is most commonly seen in alcoholics

Question 2

Other causes of Wernicke’s encephalopathy

Answer 2

Persistent vomiting, stomach cancer, dietary deficiency

Question 3

Classic triad presentation of Wernicke’s

Answer 3

ophthalmoplegia/nystagmus, ataxia and confusion

Question 4

Clinical presentation of Wernicke’s

Answer 4

nystagmus (the most common ocular sign)
ophthalmoplegia
ataxia
confusion, altered GCS
peripheral sensory neuropathy

Question 5

Investigations of Wernicke’s

Answer 5

decreased red cell transketolase
MRI

Question 6

Treatment of Wernicke’s

Answer 6

urgent replacement of thiamine

Question 7

What is Wernicke- Korsakoff syndrome?

Answer 7

characterised by the addition of antero- and retrograde amnesia and confabulation

Question 8

What is Korsakoff syndrome?

Answer 8

marked memory disorder often seen in alcoholics
thiamine deficiency causes damage and haemorrhage to the mammillary bodies of the hypothalamus and the medial thalamus