A 35 year old man with history of alcoholism presents with ophthalmoplegia, ataxia and global confusion. The treatment of choice for this patient is:
Understanding Wernicke's Encephalopathy in Alcoholism
The patient presents with ophthalmoplegia (paralysis of eye muscles), ataxia (loss of muscle coordination), and global confusion. This triad of symptoms, especially in the context of a history of alcoholism, strongly suggests Wernicke's encephalopathy.
Wernicke's encephalopathy is a serious neurological condition caused by a deficiency of thiamine (Vitamin B1). Chronic alcoholism impairs thiamine absorption and utilization, leading to this deficiency.
Choosing the Correct Treatment
The standard and most critical treatment for Wernicke's encephalopathy is the prompt administration of thiamine.
- I.V. Thiamine: This directly replenishes the body's depleted thiamine stores, addressing the root cause of the neurological symptoms. It is the first-line treatment.
- I.V. Glucose: Giving glucose without adequate thiamine can worsen the thiamine deficiency by increasing metabolic demand, potentially precipitating or worsening encephalopathy. It is generally avoided or given only after thiamine administration.
- I.V. Mannitol: Mannitol is used to reduce intracranial pressure, which is not the primary issue in untreated Wernicke's encephalopathy.
- I.V. Immunoglobulin: IVIG is used for immune-mediated disorders and is not indicated for thiamine deficiency.
Therefore, intravenous (I.V.) thiamine is the treatment of choice.
Important Questions from Vitamin B Complex Deficiency
Consider the following statements regarding Wernicke-Korsakoff syndrome :
1. It is a rare complication of chronic alcohol misuse characterised by opthalmoplegia, ataxia and delirium.
2. There is damage to the mammillary bodies and dorsomedial nuclei of thalamus.
3. The underlying cause is deficiency of Vitamin B12 (Cobalamin).
4. The syndrome can also arise due to malabsorption or protracted vomiting.
Select the correct answer using the code given below:
- The classical features of Wernicke's encephalopathy are the following except:
- Vitamin B$_{12}$ deficiency can cause the following except:
- Which one of the following pairs is not correctly matched?
- Who among the following do not participate in the election of the President of India?
