Wernicke encephalopathy is an acute and reversible consequence of alcoholism, usually due to thiamine deficiency. The lesion is in the brainstem. It presents with the triad of confusion, oculomotor dysfunction (nystagmus, diplopia, gaze palsy), and gait ataxia. It’s diagnosed based on typical clinical features in an alcoholic. It’s a medical emergency which must be treated with IV thiamine, followed up by long term thiamine supplementation.
Korsakoff syndrome is a chronic and irreversible consequence of alcoholism, usually due to long-term thiamine deficiency. It’s a psychiatric syndrome which presents with short-term memory loss, disorientation, and confabulation. The patient should receive thiamine supplementation to prevent progression.
Alcoholism is the second most common cause of polyneuropathy. These patients have typical symptoms of polyneuropathy, i.e. symmetric, distal numbness, paraesthesia, pain, loss of reflexes, etc.
- Alcoholic cerebellar degeneration
- Alcoholic myopathy
- Alcoholic myelopathy
- Delirium tremens
- Provoked seizures
- Marchifava-Bignami disease