Neurologic Sequellae of Nutritional Deficiencies 02

Topic: Imaging

Created on Saturday, September 22 2007 by jdmiles

Last modified on Saturday, September 22 2007.

 
        A) Vitamin D
 
        B) Vitamin B2
 
        C) Thiamine
 
        D) Vitamin E
 
        E) Vitamin B6
 

 

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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

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A) Vitamin D

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, which are both due to a deficiency of thiamine (vitamin B1).

Vitamin D deficiency does not typically produce the lesions shown.

  (See References)

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B) Vitamin B2

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, which are both due to a deficiency of thiamine (vitamin B1).

Vitamin B2 (Riboflavin) deficiency does not typically produce the lesions shown. Ariboflavinosis is associated with mouth and tongue inflammation, and has been associated with personality changes.

  (See References)

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C) Thiamine

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, which are both due to a deficiency of thiamine (vitamin B1).

  (See References)

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D) Vitamin E

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, which are both due to a deficiency of thiamine (vitamin B1).

Vitamin E deficiency does not typically produce the lesions shown. Vitamin E deficiency leads to axonal degeneration of large, myelinated axons, leading to loss of axons in the posterior column and spinocerebellar tracts, and to peripheral neuropathy.

  (See References)

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E) Vitamin B6

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, which are both due to a deficiency of thiamine (vitamin B1).

Vitamin B6 (Pyridoxine) deficiency does not typically produce the lesions shown. B6 deficiency can produce dermatitis, inflammation of the mouth and tongue, and neurologic symptoms including peripheral neuropathy, personality changes, depression, confusion, and EEG changes. In infants, B6 deficiency can also produce seizures.

  (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.
4. Braunwald, E., Fauci, A.S., Kasper, D.L., Hauser, S.L., Longo, D.L., and Jameson, J.L. (Eds.) (2001). Harrison's Principles of Internal Medicine, 15th Edition. McGraw Hill. New York.

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Neurologic Sequellae of Nutritional Deficiencies 02
Question ID: 092207213
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 09/22/2007
Modified: 09/22/2007
Estimated Permutations: 327600