A 25 year old female with 16 weeks of gestation presents with excess vomiting, apathy, ataxia, nystagmus and ophthalmoplegia. The diagnosis is
Wernicke's encephalopathy
Hyperemesis gravidarum
Chorea gravidarum
Korsakoff's encephalopathy
(A) Wernicke's encephalopathy# Features of WERNICKE'S DISEASE:> Wernicke's disease is a common and preventable disorder due to a deficiency of thiamine> Characteristic clinical Triad is that of Ophthalmoplegia, Ataxia, & Global confusion. Only 1/3rd of patients with acute Wernicke's disease present with the classic clinical triad.> Most patients are profoundly disoriented, indifferent, and inattentive, although rarely they have an agitated delirium related to ethanol withdrawal.> If the disease is not treated, stupor, coma, and death may ensue.> Ocular motor abnormalities include horizontal nystagmus on lateral gaze, lateral rectus palsy (usually bilateral), conjugate gaze palsies, and rarely ptosis.> Gait ataxia probably results from a combination of polyneuropathy, cerebellar involvement, and vestibular paresis.> Pupils are usually spared, but they may become miotic with advanced disease.> Tachycardia & postural hypotension may be related to impaired function of the autonomic nervous system or to the coexisterce of cardiovascular beriberi.> Most common cause of Wernike's disease is noise-induced hearing loss.> Other causes include: Neurological damage - Multiple sclerosis, Ear infections, Oxidative stress, Emotional stress.
Miscellaneous