Wernicke's Encephalopathy Flashcards
What is Wernicke’s encephalopathy.
Thiamine (vitamin B1) deficiency with a classical triad of:
Confusion.
Ataxia (wide-based gait).
Ophthalmoplegia (nystagmus, lateral rectus or conjugate gaze palsies).
What is the pathology of Wernicke’s encephalopathy. (5)
There is inadequate dietary intake of B1.
Decreased GI absorption.
Impaired utilization of thiamine resulting in focal areas of bran damage.
Areas of periaqueductal punctate haemorrhages too (mechanism unclear.
Who is most commonly diagnosed with Wernicke’s encephalopathy.
Alcoholics.
What are the other symptoms of Wernecke’s encephalopathy. (4)
Memory disturbance.
Hypotension.
Hypothermia.
Reduced consciousness.
What are some recognised causes of Wernicke’s encephalopathy. (6)
Chronic alcoholism. Eating disorders. Malnutrition. prolonged vomiting (eg with chemo). GI malignancy. Hyperemesis gravidarum.
How is the diagnosis for Wernecke’s encephalopathy made.
Clinically.
What is the prognosis for patients with Wernicke’s encephalopathy. (3)
Untreated, death occurs in 20%.
Untreated Korsakoff’s psychosis occurs in 85% - a quarter of whom will require long term institutional care.