Wernicke’s encephalopathy, during refeeding syndrome, can be precipitated in deficiency of which of the following vitamin: September 2011
**Core Concept**
Wernicke's encephalopathy is a serious medical condition characterized by a triad of confusion, ophthalmoplegia, and ataxia. It is primarily caused by a deficiency in a specific vitamin, which is essential for the proper functioning of the nervous system.
**Why the Correct Answer is Right**
Thiamin, also known as vitamin B1, plays a crucial role in the metabolism of glucose and the maintenance of the nervous system. In the context of refeeding syndrome, thiamin deficiency can lead to an accumulation of glucose in the bloodstream, causing an osmotic shift of water into the brain cells, resulting in cerebral edema and the characteristic symptoms of Wernicke's encephalopathy. The enzyme transketolase is dependent on thiamin pyrophosphate, which is the active form of thiamin, and its deficiency can be measured to diagnose thiamin deficiency.
**Why Each Wrong Option is Incorrect**
**Option A:** Riboflavin is another B vitamin, but its deficiency is primarily associated with skin and mucous membrane disorders, such as angular cheilitis and glossitis, rather than neurological symptoms.
**Option B:** Pyridoxine, or vitamin B6, is involved in many enzymatic reactions, including neurotransmitter synthesis, but its deficiency is more commonly associated with neurological symptoms such as neuropathy and seizures, rather than Wernicke's encephalopathy.
**Option D:** Vitamin C is essential for collagen synthesis and iron absorption, but its deficiency is more commonly associated with scurvy, a condition characterized by fatigue, malaise, and bleeding gums, rather than Wernicke's encephalopathy.
**Clinical Pearl / High-Yield Fact**
The "3 Ts" of Wernicke's encephalopathy are thiamin deficiency, triad of symptoms (confusion, ophthalmoplegia, and ataxia), and timely treatment with thiamin to prevent long-term neurological damage.
**✓ Correct Answer: C. Thiamin**