Wernicke's Encephalopathy Flashcards

1
Q

What is Wernicke’s encephalopathy.

A

Thiamine (vitamin B1) deficiency with a classical triad of:
Confusion.
Ataxia (wide-based gait).
Ophthalmoplegia (nystagmus, lateral rectus or conjugate gaze palsies).

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2
Q

What is the pathology of Wernicke’s encephalopathy. (5)

A

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.

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3
Q

Who is most commonly diagnosed with Wernicke’s encephalopathy.

A

Alcoholics.

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4
Q

What are the other symptoms of Wernecke’s encephalopathy. (4)

A

Memory disturbance.
Hypotension.
Hypothermia.
Reduced consciousness.

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5
Q

What are some recognised causes of Wernicke’s encephalopathy. (6)

A
Chronic alcoholism. 
Eating disorders. 
Malnutrition. 
prolonged vomiting (eg with chemo). 
GI malignancy. 
Hyperemesis gravidarum.
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6
Q

How is the diagnosis for Wernecke’s encephalopathy made.

A

Clinically.

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7
Q

What is the prognosis for patients with Wernicke’s encephalopathy. (3)

A

Untreated, death occurs in 20%.

Untreated Korsakoff’s psychosis occurs in 85% - a quarter of whom will require long term institutional care.

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