Due to memory loss and frequent falls, a 62-year-old man is brought to the office by his son. The patient has been living alone since his wife died a year ago. His visiting son discovered his father in deplorable living circumstances. The patient was forgetful and didn't recall where certain belongings in his residence, where he had resided for almost 20 years, were located. His walk is extremely shaky, and he has fallen multiple times. According to his son, his father has always been "a drinker" and may have been drinking recently. The patient appears unconcerned about his son's fears and claims to be OK. The vital indicators are within normal ranges. On physical examination, bilateral lateral gaze palsy and nystagmus are present. Muscle strength and deep tendon reflexes are normal, but the gait is ataxic. On memory testing, he recalls 0 out of 3 objects after 5 minutes. A lesion of which of the following labeled structures on a normal brain MRI is most specifically associated with this patient's current condition?

Question

Due to memory loss and frequent falls, a 62-year-old man is brought to the office by his son. The patient has been living alone since his wife died a year ago. His visiting son discovered his father in deplorable living circumstances. The patient was forgetful and didn't recall where certain belongings in his residence, where he had resided for almost 20 years, were located. His walk is extremely shaky, and he has fallen multiple times. According to his son, his father has always been "a drinker" and may have been drinking recently. The patient appears unconcerned about his son's fears and claims to be OK. The vital indicators are within normal ranges. On physical examination, bilateral lateral gaze palsy and nystagmus are present.  Muscle strength and deep tendon reflexes are normal, but the gait is ataxic.  On memory testing, he recalls 0 out of 3 objects after 5 minutes.  A lesion of which of the following labeled structures on a normal brain MRI is most specifically associated with this patient's current condition?

Quizplus · Accepted Answer

Eductional Objective: Wernicke encephalopathy is a thiamine deficient condition that is characterized by oculomotor dysfunction, encephalopathy, and ataxia. Korsakoff syndrome is caused by chronic deficit (eg, anterograde and retrograde amnesia, confabulation, apathy). Thiamine is involved in glucose metabolism, and regions of the brain with high metabolic needs, such as the mammillary bodies, are particularly vulnerable.

Due to Memory Loss and Frequent Falls, a 62-Year-Old Man