Degenerative brain disorder caused by lack of thiamine (vitamin B1) and damage to thalamus & hypothalamus

Triad of

1. Encephalopathy: confusion/disorientation

2. Ocular motor dysfunction: nystagmus, lateral rectus palsy

3. Ataxia: gait, stance

Causes:

• Alcohol abuse

• Dietary deficiencies

• Prolonged vomiting

• Eating disorders

• Effects of chemotherapy

Management

• Parenteral thiamine

  • Intramuscular Pabrinex contains thiamine (B1), riboflavin (B2), pyridoxine (B6) and nicotinamide, and also benzyl alcohol as a local anaesthetic.

  • Anaphylaxis is a rare complication of Pabrinex treatment and is more likely to occur with IV use. Anaphylaxis is extremely rare after IM administration and therefore this is the preferred route of administration

  • drugs to treat anaphylaxis should be available

• Followed by oral thiamine