Alcoholic, abstinence since 10 years. Develops dysarthria, shuffling gait and intention tremors:
Ans. c. Acquired hepatocerebral degenerationACQUIRED HEPATOCEREBRAL DEGENERATIONIt is a progressive neuropsychiatric and movement disorderIt occurs in chronic liver failure or acute fulminant hepatic failure.Both Hyperglycemia and hypoglycemia are associated with it.Cerebral sign: Tremor, Akinesia, Chorea, dysarthria, ataxia, dystoria, and myoclonus.Pathology remains unclear, but it is thought to be due to intracerebral accumulation of manganese.Radiological findings: Paramagnetic material deposition observes in globus pallidus, thalami and midbrain.Fig. 1: Acquired hepatocerebral degeneration: Typical hyperintense signal on Tl-weighted sequences involves substantia nigra (arrow inA. nucleus (arrowhead in A), and pallidum (arrow in B)WERNICKE'S ENCEPHALOPATHYIt occurs due to deficiency of thiamine.It occurs is most cases due to excess alcohol consumption.Hall marks: Global confusion, Ophthalmoplegia and Ataxia. (GOA)Pathology: Periventricular lesions surround the third ventricle, aqueduct and fourth ventricle, with petechial hemorrhages in occasional acute cases and atrophy of the mammillary bodies in most chronic cases.Radiological Findings: Abnormal enhancement of mammillary bodies.Fig. 2: Wernicke's Encephalopathy: Colliculi and mammillary bodies are involved and there is a clear contrast enhancement in both structures
Wilsons
Wernickes disease
Acquired hepatocerebral degeneration
Degeneration due to iron deposition
C.N.S.