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A 39-year-old woman presents to the ED with agitation, tremors, visual hallucinations, fever, and tachycardia. The eye examination reveals nystagmus and a sixth cranial nerve palsy. Which of the following conditions best describes this clinical scenario?

A. Korsakoff psychosis
B. Wernicke encephalopathy
C. acute dystonia
D. acute cocaine toxicity

User Maxjakob
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1 Answer

4 votes

Final answer:

The clinical scenario described is most indicative of (B) Wernicke encephalopathy, a condition caused by thiamine deficiency associated with the classic triad of confusion, ataxia, and ophthalmoplegia, which may include nystagmus and a sixth cranial nerve palsy.

Step-by-step explanation:

The condition that best describes the clinical scenario of a 39-year-old woman presenting with agitation, tremors, visual hallucinations, fever, tachycardia, nystagmus, and a sixth cranial nerve palsy is Wernicke encephalopathy. Wernicke encephalopathy is a neurologic disorder typically caused by thiamine (vitamin B1) deficiency, which is often associated with excessive alcohol consumption. It is characterized by the classic triad of confusion, ataxia, and ophthalmoplegia, but these symptoms may not always present together. The presence of nystagmus and a sixth cranial nerve palsy points specifically to this condition.

Other conditions mentioned in the question do not align closely with this symptom profile. Korsakoff psychosis is often seen chronically following an acute episode of Wernicke encephalopathy and is characterized by severe memory impairment. Acute dystonia generally refers to involuntary muscle contractions leading to abnormal postures, and acute cocaine toxicity often presents with psychiatric and sympathetic overdrive features, lacking specific eye movement abnormalities seen in Wernicke encephalopathy.

User Sayantankhan
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