Q: Unreactive pupil in Wernicke's Encephalopathy (WE) is found to be associated with? (select one)
A) Hypothermia B) Hyperthermia
The objective of the above question is to address the initial management in WE. On initial exam in patients suspecting of having WE, if found to have unreactive pupil should be checked for the need for normothermia. Hypothermia may exacerbate the morbidity and mortality in WE. This is due to dysfunction in the thermoregulatory functions of the hypothalamus. Unreactive pupil and hypothermia are also found to be associated with autonomic dysfunction and hypotension. This calls for the rewarming of the patient.
1. Harper CG, Giles M, Finlay-Jones R. Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy. J Neurol Neurosurg Psychiatry 1986; 49:341.
2. Philip G, Smith JF. Hypothermia and Wernicke's encephalopathy. Lancet 1973; 2:122.