Monday, January 29, 2007

Neurologic cosequences of starvation

Basoglu M et al. Neurological consequences of prolonged hunger strike. Eur J Neurol 2006; 13; 1089-1097.

Extensive studies were carried out of Turkish hunger strikers. Patients typically developed gaze evoked nystagmus (vertical in 9/41), limb ataxia in 3, and lateral rectus palsy in 14. All had muscle atrophy but only 11 were demonstrably weak. 15 had paresthesias, and 17 had abnormal vibratory or position sense. All patients were treated with thiamine when they reached the point of confusion. Nystagmus and ataxia resolved, sensory function normalized, but anterograde and retrograde amnesia remained in all.

Michael Rubin commented that although Wernicke-Korsakoff s. was diagnosed in all, osmotic myelinolysis with shift from normonatremic to hypernatremic state was reported in an Algerian hunger striker (Neurology 2005; 64;574-5).