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Psychotherapy: 91b - Neurology and Nutrition

Psychology15 CardsCreated about 2 months ago

This flashcard set reviews the causes and hallmark signs of Wernicke’s Encephalopathy (due to thiamine deficiency) and pellagra (due to niacin/B3 deficiency). It highlights key symptoms—ataxia, nystagmus, confusion for Wernicke’s, and the classic 3 Ds for pellagra: dermatitis, diarrhea, and dementia—both often seen in malnourished individuals, particularly those with alcohol use disorder.

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What are the signs of Wernicke’s Encephalopathy?

What is it caused by?

  • Ataxia

  • Abnormal eye movements

    • Nystagmus

  • Confusion

Caused by thiamine deficiency - treat with thiamine to prevent Korsakoff symptoms!

(Amnesia, confabulation, peripheral neruopathy)

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Key Terms

Term
Definition

What are the signs of Wernicke’s Encephalopathy?

What is it caused by?

  • Ataxia

  • Abnormal eye movements

    • What is pellagra?

      What are the signs?

      Pellagra = Niacin (B3) deficiency

      Dermatitis, Diarrhea, Dementia

      • Methotrexate is associated with what deficiency?

        Folate (B9)

      What is the appearance of Wernicke’s encephalopathy on MRI?

      Medial thalami and mamillary body hyperintensity

      What are the symptoms of pyridoxine (B6) deficiency


      Sensory polyneuropathy

      Often caused by treatmetn with isoniazid

      Dermatitis, dementia, and diarrhea are signs of which vitamin deficiency?

      Niacin (B3) deficiency

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Psychotherapy: 91b - Neurology and Nutrition
TermDefinition

What are the signs of Wernicke’s Encephalopathy?

What is it caused by?

  • Ataxia

  • Abnormal eye movements

    • Nystagmus

  • Confusion

Caused by thiamine deficiency - treat with thiamine to prevent Korsakoff symptoms!

(Amnesia, confabulation, peripheral neruopathy)

What is pellagra?

What are the signs?

Pellagra = Niacin (B3) deficiency

Dermatitis, Diarrhea, Dementia

  • Often seen in people who have malnourishment + alcohol use disorder

  • Often in underdeveloped countries

Methotrexate is associated with what deficiency?

Folate (B9)

What is the appearance of Wernicke’s encephalopathy on MRI?

Medial thalami and mamillary body hyperintensity

What are the symptoms of pyridoxine (B6) deficiency


Sensory polyneuropathy

Often caused by treatmetn with isoniazid

Dermatitis, dementia, and diarrhea are signs of which vitamin deficiency?

Niacin (B3) deficiency

What is the treatment for cobalamin (B12) deficiency?

B12 supplementation for life

Isoniazid is associated with which deficiency?

Pyridoxine (B6)

How is thiamine deficiency treated?

Give thiamine (B1) before or concurrently with glucose

  • Giving glucose before thiamine will make thiamine deficiency worse, because thiamine is needed to metabolize glucose

Mamillary body hyperintensity is pathognomonic for which deficiency?

Thiamine deficiency

However, imaging will more commonly show hyperintensity of the medial thalami

May also see hyperintensity in the periaqueductal grey

Which syndrome is associated with cobalmin (B12) deficiency?

What are the symptoms?

Subacute combined degeneration

  • Affects corticospinal and dorsal column

  • Mild weakness

  • Paresthesias

  • Ataxic paraplegia

    • Unsteadiness, stiffness/weakness in legs

  • Cognitive changes

    • Irritability, apathy, somnolence

  • Scotoma

Irritable, unsteady, pins and needles, blind spot

Which labs should be checked in a patient with suspected cobalamin (B12) deficiency?

  • Serum B12

    • <100 will have neurological symptoms

    • <200 needs further eval even w/o symtpoms

    • 200-300 may still be deficient

  • Homocysteine

    • If high => intracellular B12 deficiency

  • Methylmalonic acid

    • If high => intracellular B12 deficiency

  • Antibody to IF

  • Megaloblastic anemia

Which syndromes may be caused by thiamine (B1) deficiency?


  • Wernicke-Korsakoff

    • Ataxia, confusion, abnormal eye movements

    • Followed by psychosis (amnesia, confabulation) and neuropathy

  • Beri Beri

    • Length-dependent peripheral polyneuropathy +/- edema

Deficiency of which vitamin is associated with subacute combined degeneration?

Describe the symtoms

Cobalamin (B12) deficiency)

  • Weakness

  • Paresthesia

  • Gait unsteadiness, stiffness/weakness in legs

  • Irritability, apathy, somnolence

  • Scotoma

High levels of which compounds indicate intracellular cobalamin (B12) deficiency?

Homocysteine

Methylmalonic acid

May indicate cobalamin deficiency even if cobalamin levels are normal