A 54-year-old woman is brought to the physician by her brother for confusion and agitation. She is unable to personally give a history. Her brother says she has a problem with alcohol use and that he found an empty bottle of vodka on the counter at her home. She appears disheveled. Her temperature is 37°C (98.6°F), pulse is 85/min, and blood pressure is 140/95 mm Hg. On mental status examination, she is confused and oriented only to person. She recalls 0 out of 3 words after 5 minutes. She cannot perform serial sevens and is unable to repeat seven digits forward and five in reverse sequence. Neurologic examination shows horizontal nystagmus on lateral gaze. Thiamine infusion is started immediately, and his condition improves significantly over the next several days. Which of the following neurologic findings is most likely to persist despite treatment?

Question

A 54-year-old woman is brought to the physician by her brother for confusion and agitation. She is unable to personally give a history. Her brother says she has a problem with alcohol use and that he found an empty bottle of vodka on the counter at her home. She appears disheveled. Her temperature is 37°C (98.6°F), pulse is 85/min, and blood pressure is 140/95 mm Hg. On mental status examination, she is confused and oriented only to person. She recalls 0 out of 3 words after 5 minutes. She cannot perform serial sevens and is unable to repeat seven digits forward and five in reverse sequence. Neurologic examination shows horizontal nystagmus on lateral gaze. Thiamine infusion is started immediately, and his condition improves significantly over the next several days.  Which of the following neurologic findings is most likely to persist despite treatment?

Quizplus · Accepted Answer

Eductional Objective: Oculomotor dysfunction, ataxia, and confusion form the triad of Wernicke syndrome.  Most of these symptoms usually resolve after thiamine administration.  Korsakoff syndrome is a complication of Wernicke encephalopathy, the hallmarks of which are permanent memory loss and confabulation.

A 54-Year-Old Woman Is Brought to the Physician by Her