Wernickes encephalopathy

Question 1

What is wernicke’s encephalopathy

Answer 1

neuropsychiatric disorder caused by thiamine deficiency most commonly seen in alcoholics

Question 2

What occurs pathophysiologically in wernicke’s encephalopathy

Answer 2

petechial haemorrhages occur in variety of structures in brain including the mamillary bodies and ventricle walls

Question 3

How may someone present

Answer 3

oculomotor dysfunction-
nystagmus
ophthalmoplegia - lateral rectus palsy , conjugate gaze palsy

gait ataxia - wide broad

encephalopathy - confusion , disorientation, indifference and inattentiveness

peripheral sensory neuropathy

Question 4

What investigations are required

Answer 4

decreased red cell transketolase( due to thiamine deficiency)

MRI -

Question 5

What is treatment

Answer 5

URGENT REPLACEMENT OF THIAMINE

-PABRINEX IV
- prevent condition from progressing to Korsakoffs psychosis

Question 6

What is Korsakoff’s syndrome

Answer 6

if untreated wernicke’s encephalopathy will progress to this

characterised by addition of antero- and retrograde amnesia and confabulation ( generation of false memories )