Metabolic/Nutritional Disorders with Neurological Consequences Flashcards
Pallegra - what is it
disease from deficiency in niacin, B complex vitamin (B3)
4 D’s of Pallegra
Diarrhea
Dermatitis
Dementia
Death
Wernicke’s Syndrome/Encephalopathy - what is it
Complication of thiamine (B1) deficiency
Most often associated with chronic alcoholism but occurs with poor nutrition
Alcohol and non alcohol related causes
Wernicke’s Syndrome/Encephalopathy - Two of the non-alcoholic related causes can be what
Post op from bariatric surgery Hyperemesis graveidarum (with preg)
Wernicke’s Syndrome/Encephalopathy - s/s - neuro impairments
Confusion
Ataxia with possible tremors
Nystagmus, Diplopia, Ptosis
Karsakoff’s Syndrome - what is it
Chronic memory disorder caused by deficiency of thiamine (B1)
Karsakoff’s Syndrome and Wernicke’s
Many think KS is the chronic phase of WE, so WE occurs first and then KS is the chronic extension of the disease process
Karsakoff’s Syndrome - s/s
Worse than Wernicke’s - worse cognitively
Alcoholic Neuropathy - what is it
Peripheral nerve damage as a result of chronic alcohol abuse
Alcoholic Neuropathy - Pathophysiology
Alcoholism and poor nutrition leading to deficiencies in thiamine, folate, niacin, B6, B12, and vitamin E
All are important for proper nerve function
Peripheral diabetic neuropathy - what is it
Nerve damage throughout the body occurring secondary to diabetes
Often occurs first in distal LE
Phenylketonuria (PKU) - what is it
Rare inherited disease that causes amino acid build up in the body
amino acid = phenylalanine
PKU - what causes the build up of the amino acid
The gene responsible for creating the enzyme to break down the amino acid is defective and leads to an elevated, toxic level
PKU - pregnancy
If it is not controlled in the mother during pregnancy, it can affect the baby’s development even if the baby does not inherit the defect!!!
PKU - Neuro impairments
Difficulty in decision making, problem solving planning, lower IQ, slower thinking
Seizures, tremors, tics or stiffness of limbs
PKU - what are babies born to PKU mothers at risk for
Intellectual disability because exposure to phenylalanine amino acid
Delays mental and social skills
Can also see hyperactive bx problems
Pallegra - s/s and functional limitations
Ataxia and weakness (difficulty walking, balance)
Paralysis of extremities (difficulty walking, transfers)
Peripheral neuritis (nerve pain)
Wernicke’s Syndrome/Encephalopathy - Classic triad of s/s
Ataxia
Confusion
Eye problems
Wernicke’s Syndrome/Encephalopathy - Possible lesion sites
Brainstem tegmentum Hypothalamus Medulla Dorsomedial nucleus of thalamus Cerebellum
Karsakoff’s Syndrome - Volume deficits in ___
mamillary bodies thalamus cerebellum pons hippocampus FRONTAL LOBE (cog issues)
Karsakoff’s Syndrome - Triad
Ataxia
Nystagmus
Confusion
Similar to WE except KE is distinct because of chronic memory/cognitive impairments
Alcoholic Neuropathy - Neurological impairments
Symptoms begin distally and mvoe proximally as disease progresses
Presents as a polyneuropathy (both sides of the body)
Peripheral diabetic neuropathy - Neuro Impairments
Pain Numbness Weakness Reduced ability to feel temp changes Loss of reflexes Muscle atrophy Feeling like they are wearing socks or gloves
Peripheral diabetic neuropathy - typically presents as a
Polyneuropathy - also called distal symmetric neuropathy or sensorimotor neuropathy
Nerve damage in the arms and legs with feet and legs likely being affected before the hands and arms
Peripheral diabetic neuropathy - typically starts with what symptoms
sensory symptoms first, then weakness
Peripheral diabetic neuropathy - loss of sensation due to what
Loss of sensation due to disruption of both large fibers (touch, vibration) and small fibers (pain, temp)
