Alcoholism, loss of memory and ataxic gait (124/1700)

Pt with hx of alcoholism, ataxic gait, hallucinations and loss of memory. He is given acamprosate.
What other drug can you give with this?
a. Chlordiazepoxide
b. Thiamine
c. Diazepam
d. Disulfiram
e. Haloperidol




























answer: B


Wernicke-Korsakoff Syndrome
• alcohol-induced amnestic disorders due to thiamine deficiency
• necrotic lesions: mammillary bodies, thalamus, brainstem
• Wernicke’s encephalopathy (acute and reversible): triad of nystagmus (CN VI palsy), ataxia, and
confusion
• Korsakoff’s syndrome (chronic and only 20% reversible with treatment): anterograde amnesia
and confabulations; cannot occur during an acute delirium or dementia and must persist
beyond usual duration of intoxication/withdrawal
• management
ƒ Wernicke’s: thiamine 100 mg PO OD x 1-2 wk
ƒ Korsakoff’s: thiamine 100 mg PO bid/tid x 3-12 mo