Wenicke's Encephalopathy Flashcards
Define Wernicke’s Encephalopathy?
The presence of neurological symptoms caused by biochemical lesions of the CNS following exhaustion of Vitamin B (particularly thiamine) reserves
What is the main cause of Wernicke’s Encephalopathy?
Chronic Alcohol Consumption
What does Chronic Alcohol Consumption result in?
Thiamine deficiency
How does chronic alcohol consumption cause Thiamine deficiency?
Causes:
- Inadequate nutritional thiamine intake
- Decreased thiamine absorption
- Impaired thiamine ultilsation by cells
What are other conditions that cause Thiamine deficiency?
Chronic subdural haematoma
AIDS
Hyperemesis gravidarum
Thyrotoxicosis
What does Thiamine deficiency result in?
Abnormal cellular function in the cerebral cortex, hypothalmus and cerebellum
What is the epidemiology of Wernicke’s Encephalopathy?
Alcohol-related brain damage accounts for 10-24% of all dementia
Prevalence rates are higher in areas of socio-economic deprivation
Higher prevalence in 50-60 yrs old
What are the presenting sy,ptoms of Wernicke’s Encephalopathy?
Vision changes Loss of muscle coordination: unsteady gait Loss of memory Inability to form new memories Hallucinations
What vision changes do we see in Wernicke’s Encephalopathy?
Diplopia
Eye movement abnormalities
Deprivation
What are the classical signs of Wernicke’s Encephalopathy?
Triad of signs:
- confusion
- Ophthalmoplegia
- Ataxia
What are the other signs of Wernicke’s Encephalopathy?
Patient is usually mentally alert with vocabulary, comprehension, motor skills, social habits and naming ability maintained Some show signs suggestive polyneuropathy Reflexes may be decreased Abnormal gait and coordination Eye abnormalities on movement Low temperature Rapid pulse Some may be cachectic
What eye abnormalities do we see on movement for Wernicke’s Encephalopathy?
Nystagmus
Bilateral lateral rectus palsy
Conjugate gaze palsy
What is Korsakoff’s Psychosis?
Occurs when the condition deteriorates further, leading to the abnormal symptoms of:
- Amnesia
- Confabulation
What is diagnosis of Wernicke’s Encephalopathy based on?
History and examination
What arethe possible tests for Wernicke’s Encephalopathy?
FBC U&Es LFTs Glucose ABG Serum Thiamine CT head scan may be useful
