Management Treatment

Patients in whom cardiac and renal signs of thiamin deficiency are identified usually respond well to treatment. The dose given and route used will vary with the seriousness of the deficiency. Intravenous doses as high as 250mg/day for 14 days and intramuscular doses of

25 mg followed by thrice daily oral doses of 10 mg have been reported for wet beriberi and are followed by a marked increase in urinary output and improvement in cardiac function. Peripheral neuropathy (dry beriberi) is more resistant to treatment. Patients with the ocular signs of Wernicke's disease usually respond to two or three daily injections of 50 mg thiamin. Long-term oral treatment of other manifestations of Wernicke-Korsakoff syndrome with doses up to 50 mg/day is reported, although benefit is variable and considerably influenced by patients' ability to avoid further alcohol consumption. It is unlikely that patients receiving oral thiamin will absorb more than 5-7mg/day, but in patients likely to abuse alcohol, absorption by passive diffusion of high thiamin doses

Figure 1 Patient with dry beriberi showing evidence of motor nerve disturbances resulting in a flaccid paralysis of the extensor muscles and 'wrist drop' and 'foot drop'.

is the only way to ensured that the patient will receive any thiamin. In addition, as in all patients who show evidence of nutritional deficiency, the likelihood of other coexisting deficiencies should not be overlooked and multinutrient treatment is probably desirable.

Table 5 Features of acute infantile beriberi and frequency of occurrence

Features Frequency

Table 5 Features of acute infantile beriberi and frequency of occurrence

Features Frequency

Appearance

Pale and cyanotic appearance,

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Peripheral Neuropathy Natural Treatment Options

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