Wernicke encephalopathy Flashcards
What is Wernicke’s encephalopathy?
Neurological symptoms as a result of biochemical lesions because of vitamins B1 deficiency
What is the triad of symptoms of Wernicke’s encephalopathy?
Ocular disturbances, ataxia, and confusion
Small percentage all three, most likely in alcohol abuse
What can cause Wernicke’s encephalopathy?
Pancreatitis, liver dysfunction, coeliac disease
Vomiting
Starvation, fasting
Chemotherapy
Cancer, AIDS
Chronic inflammation, diabetes
What is the pathogenesis of Wernicke’s encephalopathy?
Three-fold injury:
- Oxidative damage
- Mitochondrial injury
- Stimulation of pro-apoptotic pathway
These pathways cause lesions in different parts of the brain
How would you diagnose Wernicke’s encephalopathy?
Two or more of the classic symptoms (within or outside of the triad)
What are the classic symptoms of Wernicke’s encephalopathy?
Outside the triad
Jerky eye movements, pupillary changes, vision loss, impaired vision
Hearing loss
Memory impairment, confusion, coordination, amnesia, hypothermia
How do you treat Wernicke’s encephalopathy?
Most symptoms will improve quickly if deficiencies are treated early. Memory disorder may be permanent
500 mg of thiamine hydrochloride, delivered by infusion over a 30-minute period for two to three days
Treat underlying cause
What sort of beriberi is Wernicke’s encephalopathy?
Dry
What is Beriberi?
Severe longterm thiamine deficiency
What system does wet beriberi affect?
Cardiovascular
What system does dry beriberi affect?
Nervous system
What is Wernicke–Korsakoff syndrome (WKS)?
Combined presence of Wernicke encephalopathy and Korsakoff syndrome
Due to the close relationship between these two disorders, people with either are usually diagnosed with WKS as a single syndrome
What are the main symptoms of Wernicke–Korsakoff syndrome?
Vision changes, ataxia, memory impairment
What is ataxia?
Lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in eye movements
Who is most likely to suffer from Wernicke–Korsakoff syndrome?
Alcoholics