QuestionSBA
QuestionChoice
Thiamine Deficiency is correct. This patient is presenting with the classical symptoms of Wernicke-Korsakoff syndrome: Ataxia, Confabulation and Ophthalmoplegia. Chronic alcohol abuse is a major risk factor for thiamine deficiency and thus Wernicke's encephalopathy.
10002666
a
Thiamine Deficiency
QuestionChoice
Whilst CJD is a good differential to have in mind, it is extremely rare now and does not present with Ophthalmoplegia, instead it presents with visual loss and/or blindness.
10002670
e
Creutzfeldt-Jakob disease
QuestionChoice
Whilst Delirium Tremens is an important differential given the confusion seen in this patient, and the history of alcohol abuse, it is incorrect as there are no typical features of DT, such as shaking or seizures. Also, DT is not associated with ataxia or Ophthalmoplegia.
10002667
b
Delirium Tremens
QuestionChoice
This is incorrect, as whilst HE is associated with confusion. It is not associated with both Ophthalmoplegia. Furthermore, there are no factors indicative of hepatic involvement, i.e., jaundice.
10002668
c
Hepatic Encephalopathy
QuestionChoice
This is incorrect, as the patient would be presenting with symptoms such as anxiety, shakiness, sweating, vomiting and tachycardia.
10002669
d
Alcohol Withdrawal Syndrome
Concept
Chapter
2693
4061
Vitamin deficiency syndromes
Topic
136
Gastroenterology
13080
A 52-year-old male with a long standing history of alcohol abuse is brought into the Emergency Department as he is unable to maintain balance and has speech changes. His partner who is accompanying him remarks that he often makes events up, however he genuinely believes these things to be true. On examination, you notice the patient struggles to move his eyes.

What is the underlying diagnosis?
a