Wernickes Encephalopathy Flashcards
def
a neurological emegency
thiamine (B1) deficiency resulting in neurological symptoms (wernickes triad)
what is wernickes triad
1 confusion 2 ataxia (wide-based gait) 3 opthalmoplegia (paralysis of muscles within or around the eyes)
aetiology
thiamine deficiency due to 1 decreased intake 2 malasorption 3 impaired utilization of thiamine 4 increased demand
epi
males>females
common in alcoholics, AIDs, bone marrow transplants
what are the risk factors for wernickes encephalopathy
alcoholism
AIDs
history of GI surgery (cause malasorption)
what are common causes of WE
alcoholism
eating disorders
malnutrition
prolonged vomiting with chemotherapy or pregnancy
history
very common for patients to complain of cognitive dysfunction (mental slowness, inability to concentrate, lack of interest or enthusiasm)
unsteadiness
examination
wernickes triad
1 confusion
2 ataxia (wide-based gait)
3 opthalmoplegia (paralysis of muscles within or around the eyes)
however it is very common for not all of the features of the triad to be present
investigations
a clinical diagnosis
1 bloods
-low thiamine levels
-elevated LFTs (alcoholism which is a risk factor)
2 improvement of condition with thiamine
3 decreased red cell transketolase activity
why is transketolase activity decreased in WE
transketolase activity is decreased in thiamine deficiency
what is wernicke-korsakoff syndrome
combination of wernickes encephalopathy and korsakoffs syndrome
what is korsakoff syndrome
manifestation of WE seen in chronic alcoholics
