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Beriberi

Alternative Names: Thiamine deficiency; Vitamin B1 deficiency Symptoms: Early neurologic symptoms include: Complaints of symmetric tingling or burning pain in the extremities Numbness in the extremities Vomiting Strange eye movements (nystagmus) Text Continues Below Later neurologic symptoms (Wernicke's encephalopathy) include: Mental confusion/speech difficulties Difficulty walking Coma Death If a patient with Wernicke's encephalopathy receives thiamine replacement, language problems, unusual eye movements, and walking difficulties may subside, but may be replaced by Korsakoff's syndrome, which includes memory loss, impaired ability to learn, and confabulation (making up stories to explain behavior that have little relation to reality). Heart Failure Symptoms: Shortness of breath with exertion Symmetric swelling of the lower legs Awakening at night short of breath Signs and tests: A physical examination may show signs of congestive heart failure, including symmetrically swollen lower legs, fluid in the lungs, and elevated neck veins with labored breathing, a rapid heartbeat, and an enlarged heart. The person with late-stage beriberi may be confused or have memory loss and delusions. Neurological examination may show a loss of vibratory sensation (the person is less able to sense vibration), decreased reflexes, loss of coordination, gait changes, nystagmus, drooping of the eyelids, and inability to move the eye outwards. Tests include: Measurement of blood thiamine and whole-blood or erythrocyte transketolase activity Measurement of urinary thiamine excretion Clinical response to administered thiamine (symptoms improve after the person is given thiamine supplements)

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