Tuesday, October 25, 2016

Symptoms suggestive of Wernicke's encephalopathy



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.  

26 comments:

  1. Dearest Esteems,

    We are Offering best Global Financial Service rendered to the general public with maximum satisfaction,maximum risk free. Do not miss this opportunity. Join the most trusted financial institution and secure a legitimate financial empowerment to add meaning to your life/business.

    Contact Dr. James Eric Firm via
    Email: fastloanoffer34@gmail.com
    https://urgentloanoffer22.blogspot.com/
    Whatsapp +918929509036
    Best Regards,
    Dr. James Eric.
    Executive Investment
    Consultant./Mediator/Facilitator

    ReplyDelete
    Replies
    1. My life is full of Joy and happiness now , i never believe that this will work, i have spend a lot money getting drugs from the hospital to keep me and my son healthy, it got to a point that i was waiting for a death to come because i was broke, one day i hard about this great man called Dr Ehiaguna who is well know for Herpes, HIV, and Cancer cure, i decided to email him I didn’t believe him that much, I just wanted to give him a try, he replied my mail and Needed some Information about me, then I sent it to him, and he prepared a herbal medicinAe (CURE) and, he gave my details to the Courier Office. they told me that 4days I will receive the package and after receiving it, i took the medicine as prescribed by him at the end of the two weeks, he told me to go to the hospital for a check up, and i went, surprisingly after the test the doctor confirm me Herpes simplex virus negative, and my son an i thought it was a joking, i went to other hospital and was also negative, thank you for saving our life’s, I promise I will always testify of your good works. if you are herpes simplex virus patient, contact him and I am sure you will get cured, contact him via:drehiaguna@gmail.com WHATSAPP: +2348073908953 and He also have herbs medicine to cured the following diseases; eczema,urethra wart,chronic problems.Herpes, Cancer, Als,Hepatitis, Diabetes, HPV,Infections,ulcer  ETC

      Delete
    2. Hello, everyone! I,m here to explore blogs and forum about the wonderful and most safe cure for (Herpes Virus).I was positive to the deadly virus called herpes and i lost hope because i was out casted and rejected even by my closet friends.i searched on-line to know and enquirer about cure for Herpes and i read someone testimony on how he was cured from Herpes so i decided to contact the same herbalist because i know that nature has the power to heal everything.i contacted him to know how he can help me and he told me never to worry that he will heal me with the natural herbs from God!after 2 days of contacting him, he told me that the cure has been ready and he sent it to me via DHL and it got to me after 3 days!i used the med as he instructed me (MORNING and EVENING) and i was cured!its really like a dream but i am so happy!thats the reason i decided to also add more comment of Him so that more can be saved just like me!and if you need his help, you can email him on nativehealthclinic@gmail.com, or whatsapp +2348140073965 I,m neme amber and you can get in touch with me via nemeamber@gmail.com..Contact him for help at Herpes virus HIV/AIDS CANCER COPD BRAIN TUMOR All kind of virus and disease //...

      Delete
    3. Hello viewer’s
      I don’t have much to say there are so may scammers going on online so we cant detect the real herbal medicine doctors. Thank GOD for leading me, please don’t ignore this post is real Dr Emmanuel, is a real herbal Doctor, he cured me from Herpes virus, i am living so happy and free , i was fully recovered within 4 weeks of usage of dr Emmanuel herbal medicine ,please viewers out there that have any deadly disease don't fail to contact him via his email; nativehealthclinic@gmail.com or WhatsApp/Call: +2348140073965  thanks once again to dr Emmanuel GOD bless you abundantly  
      he also cured HIV/AIDS,CANCER,GENITAL WART,COPD,BRAIN TUMOR

      Delete
  2. Hello 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}
    or whatsapp him number: +2349038382931.
    Contact him today and you will have a testimony...Good luck!

    Dr. OLIHA Also Cures:
    1. HIV/AIDS
    2. HERPES 1/2
    3. CANCER
    4. ALS (Lou Gehrig’s disease)
    5. Hepatitis B
    6. chronic pancreatic
    7. Emphysema
    8. COPD (Chronic Obstructive Pulmonary Disease

    ReplyDelete
  3. i want to inform the public how i was cured of HERPES Simplex Virus by a
    Doctor called Dr.IRABOR. i visited different hospital but they gave me list
    of drugs like Famvir, Zovirax, and Valtrex which is very expensive to treat
    the symptoms and never cured me. I was browsing through the Internet
    searching for remedy on HERPES and i saw comment of people talking about
    how Doctor IRABOR cured them. I Was scared because i never believed in the
    Internet but i was convince to give him a try because i was having no hope
    of been cured of HERPES so i decided to contact him on his email, i
    searched his email on net and i saw a lot of people testifying about his
    goodness. when i contacted him he gave me hope and send a Herbal medicine
    to me that i took and it seriously worked for me, am a free person now
    without problem, my HERPES result came out negative. You can contact him on
    his Email: driraborherbalhome@gmail.com call me+2348159922297 or whatsapp me +2348159922297 and get all your problem solved.

    1)Sickness of any kind
    2)Help to CURE Hepatitis B, HIV/AIDs CANCER and BIPOLAR
    3)Divorce, Breakup problem and To Re-unit
    4)Pregnancy problem
    5)Financial problem and Job promotion
    6)To get a good and rich life partner
    7)To Lose your wath
    8)to enlargement of pennis
    9. CANCER
    10. ALS (Lou Gehrig's disease)
    11. Hepatitis B
    12. chronic pancreatic
    13. emphysema
    14. COPD (chronic obstructive pulmonary disease)  

    ReplyDelete
  4. He heals and solve most of the problems & sickness which are failed to be healed by other doctors/healers. He solve bad luck, pregnancy problems, lost lover, sexual weakness, early ejaculation, witch-crafts, broken marriage, poverty, debts trouble, divorce, court cases, domestic problems, gambling losses, Lost jobs, promotions at work, Do you need penis enlargement? Do you want to be Rich? Do you need many children? Are you tired of jealousy people, Evil dreams, all long illnesses, blood pressure, HIV & aids, skin infections? etc. He use strong herbs & magic spells as well as powerful ancestors. Get healed today by this greatest miracle doctor who has healed many people through his experienced ancestors. Join the rest of the world to cerebrate his miracle healings. he can even read and tell you your problems before you say anything to him. He can connect you to talk to the spirit of a deceased of your family member or friend. he can also tell you your future through reading palm, play card, a mirror/water. He uses many ways of healing just to make sure that he certify his clients all over the world. he is the only traditional healer who does fully corresponds with all religious beliefs. contact him on his email address at babaka.wolf@gmail.com or Facebook at priest.babaka

    ReplyDelete
  5. I'm super excited! I finally got rid of my HSV-1. I got diagnosed of herpes back then in 2015 from my husband who never told me he had the virus. I got tested at first when i first had the virus and i My doctors prescribed Antiviral medicine for me which really helped me a lot in suppressing the virus. I finally got cured using herbal protocol ordered from Dr Osalu an African herbalist. I used his Products and it completely fought the virus and was tested negative. You can DM the herbalist for help if needed. via email  drosaluherbalhome@gmail.com. Or WhatsApp: +2348078668950. His medicine is 100% strong and active in eliminated herpes permanently. I can 't explain my feelings right now. I'm supper excited  

    ReplyDelete
  6. Am here to appreciate Dr Oliha for using his herbal medicine to cure my Herpes virus. since 4years now I have been living with this virus and it has been giving me challenges, I was so perplexed cause i have been taking several drugs to be cured but all of my effort was in vain,one morning i was browsing through the internet then i saw several testimonies about Dr. Oliha curing people from Herpes virus and immediately i contacted Dr. Oliha on his email: oliha.miraclemedicine@gmail.com , i told him about my troubles and he told me that i must be cured, gave me some instructions and which i rightly followed. so he prepared a herbal medicine for me and sent it to me which i used for 2 weeks and everything was like a dream to me and my Herpes virus was totally gone, why don't you contact him today and be free from your diseases because he is very good and honest Doctor. contact him via email; oliha.miraclemedicine@gmail.com or whatsApp him on +2349038382931

    ReplyDelete
  7. My life is full of Joy and happiness now , i never believe that this will work, i have spend a lot money getting drugs from the hospital to keep me and my son healthy, it got to a point that i was waiting for a death to come because i was broke, one day i hard about this great man called Dr Ehiaguna who is well know for Herpes, HIV, and Cancer cure, i decided to email him I didn’t believe him that much, I just wanted to give him a try, he replied my mail and Needed some Information about me, then I sent it to him, and he prepared a herbal medicinAe (CURE) and, he gave my details to the Courier Office. they told me that 4days I will receive the package and after receiving it, i took the medicine as prescribed by him at the end of the two weeks, he told me to go to the hospital for a check up, and i went, surprisingly after the test the doctor confirm me Herpes simplex virus negative, and my son an i thought it was a joking, i went to other hospital and was also negative, thank you for saving our life’s, I promise I will always testify of your good works. if you are herpes simplex virus patient, contact him and I am sure you will get cured, contact him via:drehiaguna@gmail.com WHATSAPP: +2348073908953 and He also have herbs medicine to cured the following diseases; eczema,urethra wart,chronic problems.Herpes, Cancer, Als,Hepatitis, Diabetes, HPV,Infections,ulcer  ETC

    ReplyDelete
  8. I Can't still believe that i got cured from Genital Herpes through herbal treatment from Dr Oyagu who I met through the internet, I actually couldn't believe it at first because it sounded impossible to me knowing how far I have gone just to get rid of it. Dr Oyagu send me his medicine which I took as instructed and here I am living a happy life once again, a big thanks to Dr Oyagu, I am sure there are many herbal doctors out there but Dr Oyagu did it for me, contact him oyaguherbalhome@gmail.com , also call or whatsApp him on +2348101755322

    ReplyDelete
  9. I Can't still believe that i got cured from Genital Herpes through herbal treatment from Dr Oyagu who I met through the internet, I actually couldn't believe it at first because it sounded impossible to me knowing how far I have gone just to get rid of it. Dr Oyagu send me his medicine which I took as instructed and here I am living a happy life once again, a big thanks to Dr Oyagu, I am sure there are many herbal doctors out there but Dr Oyagu did it for me, contact him oyaguherbalhome@gmail.com , also call or whatsApp him on +2348101755322

    ReplyDelete
  10. Hello, everyone! I,m here to explore blogs and forum about the wonderful and most safe cure for (Herpes Virus).I was positive to the deadly virus called herpes and i lost hope because i was out casted and rejected even by my closet friends.i searched on-line to know and enquirer about cure for Herpes and i read someone testimony on how he was cured from Herpes so i decided to contact the same herbalist because i know that nature has the power to heal everything.i contacted him to know how he can help me and he told me never to worry that he will heal me with the natural herbs from God!after 2 days of contacting him, he told me that the cure has been ready and he sent it to me via DHL and it got to me after 3 days!i used the med as he instructed me (MORNING and EVENING) and i was cured!its really like a dream but i am so happy!thats the reason i decided to also add more comment of Him so that more can be saved just like me!and if you need his help, you can email him on nativehealthclinic@gmail.com, or whatsapp +2348140073965 I,m neme amber and you can get in touch with me via nemeamber@gmail.com..Contact him for help at Herpes virus HIV/AIDS CANCER COPD BRAIN TUMOR All kind of virus and disease //...

    ReplyDelete
  11. Hello 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}
    or whatsapp him number: +2349038382931.
    Contact him today and you will have a testimony...Good luck!

    Dr. OLIHA Also Cures:
    1. HIV/AIDS
    2. HERPES 1/2
    3. CANCER
    4. ALS (Lou Gehrig’s disease)
    5. Hepatitis B
    6. chronic pancreatic
    7. Emphysema
    8. COPD (Chronic Obstructive Pulmonary Disease..........

    ReplyDelete
  12. 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
    He also cured my friend with HIV and ever since then i strongly believe he can do all things. Don't be deceived thinking he does not work, i believe if you can get in contact with this man all your troubles will be over. i have done my part in spreading the good news. Contact him through his email and you will be the next to testify of his great work.

    ReplyDelete

  13. hello everyone,my name is veronica gomez,im from united state texas,im 59 years old,I want to sincerely appreciate Mr RICHARD COSMOS who helped me with an already Program hacked ATM CARD and i was so poor without funds that i got frustrated. One morning as i was browsing on the internet, i saw different comments,said the card can witdraw $5000 per day and $50,000.in a week. people testifying of how Mr RICHARD COSMOS helped them from being poor to being rich through this already hacked ATM CARD. I was skeptical if this was true, i decided to contact one of the people giving this testimony to see proof before i contact this hacker and they proved to me beyond all doubts that it was really for real so i urgently contacted his (ultimatehackersworlds@gmail.com )and i got my already hacked atm card after i paid form the dilivery fee, if you are afraid that he is a scam, you can message me and ask me how i get the card my email:(vg2737277veronica@gmail.com) If you also want this BLANK ATM CARD i want you to contact the Hacker's on they email address;{ultimatehackersworlds@gmail.com}

    ReplyDelete
  14. Hello viewers in the world am here to share my experience on how I got cured from Herpes through the help of Dr Adigba who use his roots and herbs to cure my Herpes today am healthy and strong once again all thanks to you Dr. may you live long to continue the good work you started, as many of you out there looking for solution to your problems I will like you to give dradigba@gmail.com A try today add him on whatsapp +2348077875210

    ReplyDelete
  15. But Dr. James, Traditional Herbal Practitioner in Africa, Have cured for HIV which is extracted from some rare herbals. It is highly potential to cure AIDS 100% without any residue. Dr James herbal medicine has already passed various blogs on how he use his powerful herbals to heal all kind of diseases such as. Herpes, HIV, Diabetes, Hepatitis,HPV,Syphilis,Weak Erection,Wart Remover,Cold Sore, Epilepsy, also his herbal boost immune system as well. I'm telling this because he uses his herbal medicine to cure me from hepatitis B and HIV, which i have being living for 9 months now with no side effect. The Herbal Medicine is just as good when drinking it although i have to use rest room after drinking it which I do not really care about because i just want to get the virus out of my body, I will recommend Dr James to anyone sick out here to contact Dr James with this following information.
    Email...drjamesherbalmix@gmail.com
    Whatsapp Or Call...+2348152855846.
    He might be late to respond because he always busy with patents, but he will surely get back to you with positive response

    ReplyDelete
  16. HOW I GOT CURED FROM HERPES VIRUS I was diagnosed of HERPES virus and i have tried all I can to get cured but all to no avail,,until I saw a post in a health forum about a herbalist man who prepare herbal medications to cure all kind of diseases including HERPES virus,at first I doubted if it was real but decided to give it a try,when I contacted this herbalist via his email and he prepared a HERPES herbal cure and sent it to me via UPS delivery company service, when I received this herbal medicine, he gave me step by direction on how to apply it,after applying the way I was instructed,I was totally cured of this deadly disease called HERPES, all thanks to Dr Oyakhire Email him at droyakhire7@gmail.com this great herbal doctor via WhatsApp +2349039208180 HE CAN ALSO CURE SICKNESS LIKE
    {1}HIV/AIDS
    {2}DIABETES
    {3}EPILEPSY
    {4} BLOOD CANCER
    {5} HPV
    {6} ALS
    {7} HEPATITIS
    {8}LOVE SPELL
    {9} SICKLE AND ANAEMIA..
    or via whatsapp +2349039208180. Email at droyakhire7@gmail. com
    With him your problem are solved

    ReplyDelete
  17. Have you heard about programmed ATM card? email: (williamshackers@hotmail.com) or WhatsApp +15592016732 for enquiring on how to get the ATM programmed card.
    We have special cash loaded programmed ATM card of $5000, $10000, $15000, $20000 and any amount your choice you need for you to buy your dream car, house and to start up your own business. Our ATM card can be used to withdraw cash at any ATM or swipe, stores and POS. Our card has daily withdrawal limit depending card balance you order. Contact us via Email if you need a card email: (williamshackers@hotmail.com) or WhatsApp +15592016732.

    ReplyDelete
  18. I'm Celina Gomez from Canada, i have been cured from genital herpes with herbalist Sakura herbal Remedy.
    i have been infected with genital herpes for 1 years now , i have done so many medical treatments from different hospitals still
    not cured. On a very good day , I decided to do research on my computer on how to get rid of genital herpes,i found a post of Sarah Wilson on how she was  cured from herpes with herbalist Dr sakura  herbal remedy.
    The Herbalist email/contact number  was there as well dr.sakuraspellalter@gmail.com/ +2348160802189. I contacted him because of my illness .He needed few of my information which i did, and also sent me his medicine through FedEx courier service.
    which i received  after 3 working  days of shipment,i drink the  herbal medicine the same way Herbalist Dr Sakura instructed me too.but now my genital herpes is gone totally without any side effect or harm, may God Almighty continuing to bless him abundantly .
    you can contact him on mail/whats app dr.sakuraspellalter@gmail.com +2348110114739 or follow him on Instagram @Herbalist_sakura .you can also mail me for more information celinagomez784@gmail.com

    ReplyDelete
  19. God bless DR ANUGE for his marvelous work in my life, I was diagnosed of HERPES SIMPLEX VIRUS since 2010 and I was taking my medications, I wasn't satisfied i needed to get the HERPES out of my system, I searched about some possible cure for HERPES i saw a comment about Dr ANUGE , how he cured HERPES with his herbal medicine, I contacted him and he guided me. I asked for solutions, he started the remedy for my health, he sent me the medicine within 3days. I took the medicine as prescribed by him and 2weeks later I was cured from HERPES contact him via email dranuge@gmail.com once again thanks to you Dr ANUGE. cure the flowing virus, contact his email or add him on whatsapp   +2348164866838
    He also told me that he can cure the following diseases:
    cancer cure
    diabetes cure
    ringing ear
    herpes cure
    warts cure
    HPV cure
    HIV/AIDS cure
    get your ex back
    pregnancy herbal medicine
    prostate enlargement
    Hepatitis

    ReplyDelete
  20. I want to share my happiness to the world on how i was cured from (HERPES VIRUS) by Dr Oseremen herbal , i visited different hospital but they gave me list of drugs like Famvir, Zovirax, and Valtrex which is very expensive to treat the symptoms, but i did not have that kind of money to buy the drugs.the one i used before did not cured me. on one faithful day, a friend of my in united kingdom told me about Dr Oseremen herbal, he told me that,it is the herbal treatment that cure is husband from hepatitis B and she told me that he have cure so many people from herpes virus with is herb medicine,then she told me to contact him that he we cure me with is herb . when i contacted Dr Oseremen, he gave me hope and say that i we be cure once i get his herbal, he send the Herbal medicine to me and i take it for two weeks and it seriously worked for me, i went to the hospital to check, my HERPES result came out negative. I am so happy as i am sharing this testimony. My advice to you all who thinks that there is no cure for herpes that is Not true, just contact him and get cure from Dr Oseremen healing herbs, he also have the herb to cure any kind of hepatitis B,C A. AND DIFFERENT KIND OF SICKNESS Remember delay in treatment leads to death.. contact Dr Oseremen on is email at (Dr.Oseremenvadi@gmail.com) or whatsapp him on is Number :+2349056394313 and he we cure you with is HEALING HERB MEDICINE , thanks to Dr  Oseremen for cure me is healing herbs medicine

    ReplyDelete
  21. I started on COPD Herbal treatment from Ultimate Health Home, the treatment worked incredibly for my lungs condition. I used the herbal treatment for almost 4 months, it reversed my COPD. My severe shortness of breath, dry cough, chest tightness gradually disappeared. Reach Ultimate Health Home via their website at www.ultimatelifeclinic.com I can breath much better and It feels comfortable!

    ReplyDelete
  22. Hello everyone... Dr Ishiaku herbs is a good remedy for herpes Virus , I was a carrier of herpes virus and I saw a testimony on how Dr. Ishiaku cure Herpes Virus, I decided to contact him, and he guided me. I asked him for solutions and he started the remedies for my health. After he finish he sent me the herbs which i took for 2 weeks before asking me to go for a check up and getting there i could not believe that i was confirm HSV 2 Negative after the test, Today i am so happy because I'm free from herpes disease with the help of Dr. Ishiaku . Thank God now everything is fine, I'm cured by Dr. Ishiaku herbal medicine, I'm very thankful to God for making it possible. you can reach him on his email, i strongly recommend him to any one out here looking for a cure to herpes or any other deadly disease...Contact Dr ishiaku via email: ishiakuherbalcure@gmail.com or whats-app +2348180828544

    ReplyDelete
  23. HOW TO TRACK DOWN AND RECOVER LOST HACKED OR STOLEN BTC//ETH

    Hey guys it's Loyle Carner, a UK rapper.
    Do you need help in; retrieving stolen bitcoin, recovering scammed bitcoin, reporting a bitcoin scammer to reclaim crypto? There is only one way to go about recovering your lost money. You should hire a bitcoin recovery Master or funds recovery Master to help recover money lost to binary options forex, and bitcoin cryptocurrency scams.contact RecoveryMasters via email (Recoverymasters@email.cz) WhatsAp +1(551) 202-23-35

    ReplyDelete