Saturday 16 October 2010

MRCP revision battle 31.1: Wernicke's Encephalopathy

Day 2 of 3 for lots of neuro...


MRCP revision battle 31.1: Wernicke's Encephalopathy
MRCP revision battle 31.2: Korsakoff's Syndrome
MRCP revision battle 31.3: Multiple Sclerosis
MRCP revision battle 31.4: Menieres Disease
MRCP revision battle 31.5: CJD
MRCP revision battle 31.6: Herpes Zoster Opthalmicus
MRCP revision battle 31.7: Ramsey Hunt Syndrome




MRCP revision battle 31.1: Wernicke's Encephalopathy


Wernicke's encephalopathy is caused by thiamine (=vitamin B1) deficiency.


The classic triad associated with Wernicke's encephalopathy is:
  • opthalmoplegia
  • ataxia
  • confusion

There may also be hypothermia and hypotension.


Thiamine deficiency may result from:
  • alcoholism
  • carcinoma of stomach
  • anorexia
  • vomiting


CT brain may show petichial haemorrhages and a low red cell transketolase blood test could prove thiamine deficiency (rarely performed)


Treatment is parenteral thiamine (pabrinex)

If untreated, 20% of patients will die and 85% will develop Korsakoffs.


Which leads us nicely into revision battle 31.2: Korsakoffs syndrome....