Question

A 62-year-old with alcoholism has blurred vision for 3 weeks after treatment for an abdominal abscess due to diverticulitis with perforation, colon resection, and abscess drainage. The postoperative course included sepsis, and the visual exam shows nystagmus and ataxia. What is the likely diagnosis? A) Wernicke encephalopathy B) Retinal detachment C) Ocular melanoma D) Cerebral infarction

Answer 1

The likely diagnosis in this case is A) Wernicke encephalopathy.

Wernicke encephalopathy is a neurological disorder caused by thiamine (vitamin B1) deficiency, often seen in individuals with chronic alcoholism. The classic triad of symptoms associated with Wernicke encephalopathy includes confusion, ataxia, and ophthalmoplegia (paralysis or weakness of the muscles controlling eye movements), which can manifest as nystagmus or other eye movement abnormalities. Blurred vision can also occur due to optic nerve involvement.

The patient in this scenario has a history of alcoholism, neurological symptoms (nystagmus and ataxia), and blurred vision after a prolonged course of abdominal abscess treatment, making Wernicke encephalopathy the most likely diagnosis. Prompt treatment with thiamine supplementation is crucial to prevent further neurological damage and improve outcomes for individuals with Wernicke encephalopathy.