A 37-yrs-old alcoholic is brought to the emergency room after he was found unconscious in the street. He is hospitalized for dehydration and pneumonia. While being treated, he becomes acutely confused and agitated. He cannot move his eyes upward or to the right, and he is ataxic. Which of the following diagnosis is most likely?
A. Alcohol intoxication B. Korsakoff’s syndrome C. Alcohol delirium D. Wernicke’s encephalopathy
The
Answer is.
(D). Wernicke’s encephalopathy
Wernicke’s
encephalopathy occurs in nutritionally deficient alcoholics and is due to
thiamine deficiency and consequent damage of the thiamine- dependent brain
structures, including the mammillary bodies and the dorsomedial nucleus of the
thalamus. It presents with mental confusion, ataxia, and sixth nerve paralysis.
Wernicke’s encephalopathy is a medical emergency and can rapidly resolve with
immediate supplementation of thiamine.
