Neurological Disorders Flashcards
(25 cards)
Alcohol excess lead to ___ deficiency
Thiamine (vitamin B1)
What causes Wernicke-Korsakoff Syndrome?
Thiamine is poorly absorbed in the presence of alcohol. Alcoholics often have poor diets and get many of their calories from alcohol. Thiamine deficiency leads to Wernicke’s encephalopathy and Korsakoff syndrome.
Features of Wernicke’s encephalopathy
Confusion
Oculomotor disturbances (disturbances of eye movements)
Ataxia (difficulties with coordinated movements)
Features of Korsakoff syndrome include:
Memory impairment (retrograde and anterograde)
Behavioural changes
How serious is Wernicke’s encephalopathy?
Wernicke’s encephalopathy is a medical emergency with a high mortality rate.
How serious is Korsakoff syndrome ?
Korsakoff syndrome is often irreversible and results in patients requiring full-time institutional care.
Prevention and Tx for Wernicke-Korsakoff Syndrome
Prevention and treatment involve thiamine supplementation and abstaining from alcohol.
Other causes of wernicke’s encephalopathy?
Rarer causes include persistent vomiting, aոοrеxiа nervosa, stomach cancer, and dietary deficiency
How does wernicke’s enceophalopy affect the brain?
In Wernicke’s encephalopathy, petechial haemorrhages occur in a variety of structures in the brain including the mamillary bodies and ventricle walls.
oculomotor dysfunction in wernicke’s
nystagmus (the most common ocular sign)
ophthalmoplegia: lateral rectus palsy, conjugate gaze palsy
Features of encephalopathy
confusion, disorientation, indifference, and inattentiveness
IX for wernicke’s encephalopathy
decreased red cell transketolase
MRI
If wernicke’s is left untreated - what do you get ?
Korsakofffff !!! addition of antero- and retrograde amnesia and confabulation in addition to wernicke’s symptoms.
What is cognitive impairment?
A decline in one or more cognitive domains (e.g. memory, attention, language, executive function) beyond what is expected for age and education, but not necessarily meeting criteria for dementia.
Mild Cognitive Impairment (MCI) is a transitional state between ______________, where daily function is largely preserved.
normal ageing and dementia
Name five potential causes of cognitive impairment in older adults.
Alzheimer’s disease, vascular pathology, Parkinson’s disease, alcohol misuse, B12 or folate deficiency.
What are common symptoms of cognitive impairment?
Memory loss, word-finding difficulty, impaired judgement, disorientation, and problems with executive functioning.
What feature helps distinguish MCI from dementia?
Preservation of independent functional abilities in MCI.
What initial screening tests can be used to assess cognitive impairment?
6CIT, MoCA (Montreal Cognitive Assessment), MMSE (Mini-Mental State Examination).
What blood tests are indicated when assessing cognitive impairment?
FBC, U&Es, LFTs, glucose, TFTs, vitamin B12, folate, calcium, CRP.
When is neuroimaging warranted in cognitive impairment?
If symptoms are atypical, there is a rapid progression, or to exclude reversible causes (e.g. tumour, subdural haematoma, hydrocephalus).
What is the management approach for mild cognitive impairment (MCI)?
Monitor progression, encourage physical and cognitive activity, manage vascular risk factors, and offer support.
When should someone with MCI be referred for specialist assessment?
If rapid progression, functional decline, or high suspicion of dementia exists.
What is the risk of progression from MCI to dementia per year?
Around 10–15% per year, though some individuals remain stable or revert to normal.
