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Neurologic Sequellae of Nutritional Deficiencies 01

Topic: Imaging

Created on Saturday, September 22 2007 by jdmiles

Last modified on Saturday, September 22 2007.

This MRI most likely comes from a patient with which of the following findings?


 
        A) Ataxia, nystagmus, jaundice, and insomnia
 
        B) Ataxia, ophthalmoparesis, nystagmus, and confusion
 
        C) Confabulation, nystagmus, vertigo, and nausea
 
        D) Seizures and ataxia
 
        E) Confusion, nuchal rigidity, headache, and nausea
 

 


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This question was created on September 22, 2007 by jdmiles.
This question was last modified on September 22, 2007.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) ataxia, nystagmus, jaundice, and insomnia

This answer is incorrect.


This FLAIR MRI shows hyperintensity in the medial thalamic nuclei. This finding is characteristic of both Wernicke encephalopathy and Korsakoff dementia. The typical symptoms of Wernicke encephalopathy include ophthalmoparesis, nystagmus, ataxia, and a change in mental status characterized by confusion and apathy. Wernicke encephalopathy and Korsakoff dementia are both due to a deficiency of thiamine, and are both more common in alcoholics. Treatment of Wernicke encephalopathy requires administration of Thiamine.  Adams and Victor recommend 50mg IV and 50mg IM immediately, followed by 50mg IM daily.  (See References)

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B) ataxia, ophthalmoparesis, nystagmus, and confusion

This answer is correct.


This FLAIR MRI shows hyperintensity in the medial thalamic nuclei. This finding is characteristic of both Wernicke encephalopathy and Korsakoff dementia. The typical symptoms of Wernicke encephalopathy include ophthalmoparesis, nystagmus, ataxia, and a change in mental status characterized by confusion and apathy. Wernicke encephalopathy and Korsakoff dementia are both due to a deficiency of thiamine, and are both more common in alcoholics. Treatment of Wernicke encephalopathy requires administration of Thiamine.  Adams and Victor recommend 50mg IV and 50mg IM immediately, followed by 50mg IM daily.  (See References)

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C) confabulation, nystagmus, vertigo, and nausea

This answer is incorrect.


This FLAIR MRI shows hyperintensity in the medial thalamic nuclei. This finding is characteristic of both Wernicke encephalopathy and Korsakoff dementia. The typical symptoms of Wernicke encephalopathy include ophthalmoparesis, nystagmus, ataxia, and a change in mental status characterized by confusion and apathy. Wernicke encephalopathy and Korsakoff dementia are both due to a deficiency of thiamine, and are both more common in alcoholics. Treatment of Wernicke encephalopathy requires administration of Thiamine.  Adams and Victor recommend 50mg IV and 50mg IM immediately, followed by 50mg IM daily.  (See References)

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D) seizures and ataxia

This answer is incorrect.


This FLAIR MRI shows hyperintensity in the medial thalamic nuclei. This finding is characteristic of both Wernicke encephalopathy and Korsakoff dementia. The typical symptoms of Wernicke encephalopathy include ophthalmoparesis, nystagmus, ataxia, and a change in mental status characterized by confusion and apathy. Wernicke encephalopathy and Korsakoff dementia are both due to a deficiency of thiamine, and are both more common in alcoholics. Treatment of Wernicke encephalopathy requires administration of Thiamine.  Adams and Victor recommend 50mg IV and 50mg IM immediately, followed by 50mg IM daily.  (See References)

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E) confusion, nuchal rigidity, headache, and nausea

This answer is incorrect.


This FLAIR MRI shows hyperintensity in the medial thalamic nuclei. This finding is characteristic of both Wernicke encephalopathy and Korsakoff dementia. The typical symptoms of Wernicke encephalopathy include ophthalmoparesis, nystagmus, ataxia, and a change in mental status characterized by confusion and apathy. Wernicke encephalopathy and Korsakoff dementia are both due to a deficiency of thiamine, and are both more common in alcoholics. Treatment of Wernicke encephalopathy requires administration of Thiamine, 50mg IV once ini addition to 50mg IM daily.  (See References)

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References:

1. Victor, M., and Ropper, A.H. (2001). Adams and Victor's Principles of Neurology, 7th Edition. McGraw-Hill, New York.
2. Rowland, L.P. (Ed) (2000). Merritt's Neurology, 10th Edition. Lippincott Williams & Wilkins, Philadelphia.
3. So, Y.T., and Simon, R.P. (2004). Deficiency diseases of the nervous system. In Bradley, W.G., Daroff, R.B., Fenichel, G.M., and Jankovic, J. (Eds.). Neurology in Clinical Practice, Fourth Edition. Butterworth Heinemann, Philadelphia, pp. 1693-1708.
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imaging
Neurologic Sequellae of Nutritional Deficiencies 01
Question ID: 092207197
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 09/22/2007
Modified: 09/22/2007
Estimated Permutations: 5400
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