35 year old male comes with h/o 10 year of alcoholism and past history of ataxia with B/L lateral rectos palsy. He was admitted & treated. What changes expected to see -a) Progression to Korsakoff's psychosisb) Residual ataxia in 50% of patientsc) Extraocular palsy disappear in hourd) Immediate relief from symptoms
High-Yield Explanation
Response to thiamine treatment in Wernicke's encephalonathy
Ocular symptoms :- Earliest to respond, ophthalmoplegia (ocular palsies) improves within hours of thiamine administration. However, horizontal nystagmus may persist.
Ataxia :- Ataxia responds more slowly than ocular palsies and half the patients recover incompletely with a residual ataxia.
Encephalopathy :- Confusion and other CNS symptoms improve more slowly. As the symptoms of encephalopathy improve, Korsakoff's syndrome may become apparent in some patients.