Neuro - wernicke's encephalopathy and korsakoff

Question 1

what is wernicke’s encephalopathy?

Answer 1

acute, reversible condition caused by severe thiamine deficiency

Question 2

what vitamin is thiamine?

Answer 2

B1

Question 3

common cause of wernicke’s

Answer 3

chronic heavy alcohol use

Question 4

triad - wernicke’s

Answer 4

confusion
oculomotor dysfunction
gait ataxia

Question 5

korsakoff syndrome

Answer 5

chronic thiamine deficiency
irreversible personality changes
anterograde and retrograde amnesia
confabulation

Question 6

treating wernicke’s

Answer 6

IV thiamine
long term thiamine supplements
abstain from alcohol

Question 7

other causes

Answer 7

anorexia nervosa 
hyperthyroidism 
malignancy 
diarrhoea 
dialysis

Question 8

oculomotor dysfunction

Answer 8

dipolpia
gaze induced horizontal/vertical nystagmus
conjugate gaze palsy

Question 9

other manifestations wernicke’s

Answer 9

ANS dysfunction - hypotension, syncope

peripheral neuropathy

Question 10

confabulation

Answer 10

fabricated memories to fill in lapses in memory

Question 11

which is more common - anterograde or retrograde amnesia?

Answer 11

anterograde

Question 12

which one is reversible?

Answer 12

wernicke’s

Question 13

how are they diagnosed?

Answer 13

clinically

Question 14

tests in ambiguous cases

Answer 14

serum thiamine
serum lactate
LFT
brain MRI - mamillary bodies, thalamus

Question 15

wernicke differential diagnosis

Answer 15

cerebellar stroke
meningitis
hypoxia
postictal state

Question 16

korsakoff differential diagnosis

Answer 16

alzheimers
LBD
parkinsons

Question 17

thiamine and IV glucose

Answer 17

thiamine before IV glucose as glucose without thiamine can worsen encephalopathy