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Wernicke's Encephalopathy - #MEDSHED

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🔮 Wernicke's Encephalopathy - #MEDSHED 👹


Pathophysiology

Severe, life-threatening complication from thiamine (Vitamin B1) deficienc Thiamine deficiency results in dysregulation of the Kreb’s cycle and pentose phosphate pathway Accumulation of toxic intermediate metabolites (lactate, glutamate), leading to cytotoxic edema Vasogenic edema develops from ATP depletion and disruption of blood-brain-barrier (BBB)


🤔 Clinical Presentation

Classical triad of Wernicke’s Encephalopathy (WE) altered mental status , ataxia, and oculomotor abnormalities only found in up to 33% of patients Alcoholism contributes to a large portion of WE cases, but can also be caused by malnutrition and digestive disorders WE can manifest into permanent, irreversible neurologic deficits (Korsakof Syndrome)


🌐 Thiamine Replacement

The mainstay of therapy for WE is thiamine replacement and should be given with a high degree of clinical suspicion Dosing Thiamine 200 - 500 mg IV piggyback over 30 minutes Varying dosing recommendations Consider high-dose thiamine TID for three days in acute WE treatment


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Not medical advice. Educational purposes only. No relationships to report.


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