By Robert S.; Thimann, Kenneth V.; Marrian, G. F. Harris
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WERNICKE’SENCEPHALOPATHY I . ” In Wernicke’s original description the presenting features were ocular paralysis, a reeling gait, and disturbances of consciousness. At autopsy the dominant lesions were punctate hemorrhages in the tissue lining the third ventricle, in the corpora quadrigemina, and in the retinae. These features were present in three cases, two being chronic alcoholics and the other a case of sulfuric acid poisoning (Jacobiius, 1894). Wernicke considered the lesions to be inflammatory in origin.
1939) also report a dramatic response to sodium niacinate in a group of cases of stupor with few physical signs. I n a control group when the cause of the stupor was known, there was no improvement. Sydenstricker (1943) points out that a number of socalled “ toxic” or “exhaustion” psychoses seen in medical or surgical wards may respond strikingly to niacin. Such patients are often middleaged or elderly and have been on a poor diet for some time. The mental changes are attributed to arteriosclerosis, drug intoxication, uremia, and senile dementia.
4. Weekly incidence of various deficiency conditions compared with niacin and riboflavin contents of diet. (From Burgess, R. ) Clarke and Sneddon, 1946; Smith, 1946; Hobbs and Forbes, 1946). Prisoners in Changi Camp, Singapore, first came under observation for failing vision in June 1942. The incidence of fresh cases per month in the population is shown in Fig. 4 along with other deficiency syndromes, as well as the estimated niacin and riboflavin intake. 7%) gave a history of recent acute disease.