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- Central nervous system depressant primary interfering with GABA receptors
- Pleasure comes from release of endorphins and dopamine
Acute phase
- usually CT is done
- Quite often CT is normal
- Sometimes mild cerebral edema is seen in the form of effacement of sulci and reduced size of ventricles
Chronic phase
- Non specific atrophy: atrophy disproportionate for age and involving all areas of brain
- Non specific white matter demyelination: confluent or focal
- Cirrhosis: deposition of toxic substance in globus pallidus (T1 hyper)
- Osmotic demyelination: chronic drinkers are malnourished, dehydrated and hyponatremic. T2 hyper intense pons with sparing of corticospinal tracts
- Corpus callosum atrophy
- Marchiafava-Bignami disease: malnourished chronic alcoholics with lesions in corpus callosum. Severe hypotrophy and necrosis of corpus seen.
Wernicke’s encephalopathy
- Chronic thiamine deficiency
- Reversible
- Nystagmus, ataxia, confusion
- Ophthalmoplegia
- T2 hyperintense thalamic lesions
- T1 hyperintense atrophic mamillary bodies
Korsakoff’s dementia
- Chronic thiamine deficiency
- Irreversible
- Range of neuropsychiatric features
- Delirium, amnesia, confusion
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