A 58 year old man is brought to the emergency department in a confused state. He is unsteady on his feet. This man has a long history of alcohol abuse.
Which of the following findings would most strongly support the diagnosis of Wernicke's encephalopathy?
A. Drowsiness, jaundice and metabolic flap
B. Fluctuating conscious level with focal neurologic signs.
C. Nystagmus amd ataxia of gait.
D. Nystagmus and intention tremor
E. Tachycardia and tremulousness.
Answer And Discussion:
C. Nystagmus amd ataxia of gait.
Wernicke's encephalopathy typically presents with
- opthalmoplegia (horizontal and vertical nystagmus, weakness/paralysis of the lateral rectus muscle, weakness/paralysis of conjugate gaze)
- ataxia ( predominantly affecting gait and often without clear intentional tremor)
- confusion.
Choice A would suggest subdural hematoma
Choice D is seen in alcohol withdrawal
Choice E is seen in hepatic encephalopathy.
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ReplyDeleteHello Everyone out there,I am here to give my testimony about a Herbalist doctor who helped me . I was infected with HERPES SIMPLEX VIRUS in 2011, i went to many hospitals for cure but there was no solution, so I was thinking how can I get a solution out so that my body can be okay. One day I was in the river side thinking where I can go to get solution. so a lady walked to me telling me why am I so sad and i open up all to her telling her my problem, she told me that she can help me out, she introduce me to a doctor who uses herbal medication to cure HERPES SIMPLEX VIRUS and gave me his email, so i mail him. He told me all the things I need to do and also give me instructions to take, which I followed properly. Before I knew what is happening after two weeks the HERPES SIMPLEX VIRUS that was in my body got vanished . so if you are also heart broken and also need a help, you can also email him at {oliha.miraclemedicine@gmail.com}
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Joy and happiness is all i see around ever since i came in contact with this great man. i complained bitterly to him about me having herpes only for him to tell me it’s a minor stuff. He told me he has cured thousands of people but i did not believe until he sent me the herbal medicine and i took it as instructed by this great man, only to go to the hospital after two weeks for another test and i was confirmed negative. For the first time in four years i was getting that result. i want to use this medium to thank this great man. His name is Dr aziegbe, i came in contact with his email through a friend in UK and ever since then my live has been full with laughter and great peace of mind. i urge you all with herpes or HSV to contact him if you willing to give him a chance. you can contact him through this email DRAZIEGBE1SPELLHOME@GMAIL .COM or you can also WhatsApp him +2349035465208
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