ROSH Gastrointestinal Practice Exam

Which condition is characterized by ataxia, oculomotor dysfunction, and altered mental status?

1. Korsakoff syndrome

2. Normal pressure hydrocephalus

3. Vitamin B12 deficiency

4. Wernicke encephalopathy

The correct answer is: Wernicke encephalopathy

The condition characterized by ataxia, oculomotor dysfunction, and altered mental status is Wernicke encephalopathy. This neurological disorder is primarily associated with thiamine (vitamin B1) deficiency, often seen in individuals with chronic alcoholism, malnutrition, or certain medical conditions that impair nutrient absorption. Ataxia in this context refers to uncoordinated movements, typically affecting gait and balance due to damage to the cerebellum and other areas involved in motor control. Oculomotor dysfunction can present as nystagmus (involuntary eye movement), ophthalmoplegia (weakness of eye muscles), or other visual disturbances. Altered mental status may manifest as confusion, disorientation, and various levels of consciousness, ranging from mild cognitive impairment to coma. This triad of symptoms is a hallmark of Wernicke encephalopathy and highlights the need for timely recognition and treatment, often with thiamine supplementation, to prevent progression to a more severe condition called Korsakoff syndrome, which involves significant memory impairment and confabulation. The other conditions listed are not characterized by this specific combination of symptoms. Korsakoff syndrome, while related, is predominantly an amnesic disorder with cognitive deficits, and does