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Old 05-28-2013
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Question Alcohol Effects On Brain Structures

Ok, another one that I keep mixing up, mainly with the Thiamine pathology...

1.So, Wernicke's triad is because you gave Glucose without Thiamine-->Hemorhage in Mamilary Bodies

2.Korsakoff is because of damage to Medial Dorsal Nuclei of thalamus (& Mamillary body? The free offifical USMLE questions had this question, and they said Mammillary body is the pathology in Korsakoff)

3.Ataxia--->Purkinje layer of Cerebellar Vermis

4.Ophthalmoplegia--->Cranial nerve nuclei of III, IV, VI

5.Also, Alcohol has no effect on Amygdala and Hippocampus, right?

6.Finally, Hippocampus is first involved in Alzhemiers...Later its the Basal Forebrain Nucleus of Meynert

Did I get everything right?

Thanks a ton everyone!!!
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Old 05-28-2013
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Ok here goes:

Acute thiamine deficiency associated with alcoholism manifests as Wernicke Encephalopathy, a medical emergency.

Areas of the brain affected are: Mamillary bodies, periaqueductal areas, and Medial Dorsal nucleus of the thalamus

The cerebellar vermis that you had mentioned, according to a neuroradiology review article on wernicke encephalopathy findings, is an "atypical" MRI finding and probably not directly the result of thiamine deficiency.

Clinical symptoms are often known as "Wernicke's Triad" which consists of ataxia, ophthalmoplegia (nystagmus and impaired conjugate gaze), and confusion

Of the 80% who survive, 85% of them may end up with the aftermath of WE which is known as Korsakoff syndrome.

Korsakoff syndrome classically manifests as anterograde+retrograde amnesia + confabulations. The patients have such distorted memories that they believe these to be true i.e. making lies to fill up the gaps in memory though they are unaware that they are lying.

Areas of the brain damaged: Same as WE i.e. mamillary bodies, md nucleus, periaqueductal areas, AND the anterior nucleus

Treatment: IV thiamine is used to treat both but unlike the symptoms of WE, korsakoff syndrome symptoms are for the most part irreversible. Only 20% recover.
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Old 05-30-2013
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rapid infusion of nacl in alcoholics(hyponatremia) may cause central pontine myelinosis
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