Management of alcohol withdrawal on the USMLE exam
1st – THIAMINE
Given to prevent the progression of Wernicke’s encephalopathy (addition of glucose after thiamine)
2nd – BENZODIAZEPINE (Lorazepam or Diazepam)
Wernicke’s Encephalopathy presents with – Ataxia, Confusion, Nystagmus
Korsakoff’s – This presents with confabulations most commonly, and will almost always be in the question.
Korsakoff Psychosis – This condition can precipitate if you give glucose before thiamine. This is why we always give Thiamine before Glucose.
THIS IS WHAT SEVERE ALCOHOL WITHDRAWAL LOOKS LIKE – SEIZURES/DELIRIUM TREMENS/COMA