Pellagra and spinal myoclonus

Park K, Oeda T, Sawada H. A case of alcoholic pellegra encephalopathy presenting with spinal myoclonus.  Neurology Clinical Practice 5; 472-3. The authors present a case of alcoholic pellagra  with confusion and myoclonus responding dramatically to administration of niacin1500 mg per day starting 16 days after admission.  Essential points include: 1. Pellagra is rare in US but not in alcoholics2. Dermatitis may be subtle and not appreciated3.  Thiamine and niacin levels may be normal4.  Thiamine may cause worsening due to increased demand for niacin5.  Myoclonus in context is important to diagnosis, often stimulus sensitive6.  Severe sensory ataxia, incontinence and dysautonomia also occur and improve with treatment the 4 D's of pellagra, again, are , diarrhea, dementia, dermatitis and deathvar gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); var pageTracker = _gat._getTracker("UA-3639768-12"); pageTracker._initData(); pageTracker._trackPageview();
Source: neurologyminutiae - Category: Neurology Source Type: blogs