Inadequate thiamine can lead to which neurologic condition characterized by altered mental status, oculomotor dysfunction, and ataxia?

• A. Wernicke encephalopathy
• B. Korsakoff syndrome
• C. Pellagra
• D. Beriberi

Answer: (A)

Inadequate thiamine causes brain energy failure because thiamine is a key cofactor for enzymes that power glucose metabolism. When thiamine is deficient, the brain’s energy supply drops, leading to acute neurologic dysfunction. This specific deficiency classically presents as Wernicke encephalopathy, marked by altered mental status, oculomotor dysfunction (such as ophthalmoplegia), and gait ataxia. It’s a medical emergency; treatment with thiamine should be started promptly, even before glucose administration, to prevent progression.

If Wernicke is not treated, it can progress to Korsakoff syndrome, which involves chronic memory disturbances, confabulation, and both retrograde and anterograde amnesia, without the acute triad symptoms. Other deficiencies like Pellagra (niacin deficiency) present with dermatitis, diarrhea, and dementia, while Beriberi can cause cardiovascular or neuropathic symptoms, not the acute triad described here.