A 60-year-old man from a poor socioeconomic environment is admitted with an acute illness characterized by mental disturbances. On examination, he has bilateral sixth nerve palsy and an ataxic gait. Which of the following is the most appropriate treatment?
The patient has Wernicke's encephalopathy and requires treatment with thiamine. A delay of a few hours may permit progression to psychosis. The eye findings in Wernicke's encephalopathy include bilateral (but not necessarily symmetrical) abductor weakness or paralysis, horizontal diplopia, strabismus, and nystagmus. The nystagmus is most frequently horizontal or vertical gaze-evoked nystagmus.
thiamine
lecithin
vitamin D
phenytoin
C.N.S.