Diary of Unknown Symptoms

Mystery of the Internal Vibration

Entry for July 23, 2006

Today I looked up Wernicke’s Encephalopathy in more detail and I don’t think I have the symptoms to match. Hopefully going to a Neurologist will help. Here’s what it says:

Wernicke’s Encephalopathy

Background: Wernicke encephalopathy is a serious disorder caused by thiamine deficiency. Dr. Carl Wernicke, a Polish neurologist, described it in 1881 as a triad of acute mental confusion, ataxia, and ophthalmoplegia. Korsakoff amnestic syndrome is a late neuropsychiatric manifestation of Wernicke encephalopathy with memory loss and confabulation; hence, the condition is usually known as Wernicke-Korsakoff syndrome or psychosis. It is most often seen in alcoholics, but it can be seen in disorders associated with malnutrition and also in chronic hemodialysis patients, and in patients with AIDS. Although not frequently diagnosed, the disease is more frequent than commonly supposed.

Pathophysiology: Many factors interact to reduce intracellular thiamine in brain cells. As the thiamine (vitamin B-1) deficiency develops, enzymes and systems dependent on thiamine begin to function less well, leading eventually to cell death.

Thiamine deficiency affects the thiamine-dependent enzyme transketolase involved in the pentose phosphate pathway leading to problems in the maintenance of the myelin sheaths in the nervous system, metabolism of lipids and glucose, and production of branched chain amino acids.

Thiamine deficiency also reduces the conversion of pyruvate to acetyl coenzyme A, which results in less efficient oxidative phosphorylation and increased lactic acid production. In addition, thiamine is also a cofactor for the conversion of alpha ketoglutarate to succinate, which is important in GABA metabolism and the electrical stimulation of neurons.

Thiamine deficiencies are often associated with other B vitamin deficiencies. Vitamin B deficiencies affect the efficacy of the citric acid cycle and result in cellular energy deficits.

This disease, due to a nutritional deficiency of thiamine, can be fatal if not treated. Typically the oculomotor findings are weakness of abduction (usually bilateral but not symmetrical), gaze evoked nystagmus, internuclear opthalmoplegia, vertical nystagmus in the primary position, and a decreased VOR. In monkeys and humans, lesions have been found cranial nerve nuclei III, IV, VI and VIII, as well as the thalamus, hypothalamus, periaquiductal gray, cerebellar vermis and the dorsal nucleus of the vagus.

I don’t think I have Wernicke encephalopathy as I don’t have a Thiamine deficiency. Because there are no diseases associated with a riboflavin deficiency, I don’t think I have anything more serious than a simple vitamin deficiency. That’s probably why the doctors can’t find anything wrong.

In a way, I was very lucky to have a B2 deficiency. It could’ve been a lot worse…

July 23, 2006 Posted by | Health | , | Leave a comment


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