How does thiamine deficiency affect the brain stem

How does thiamine deficiency affect the brain stem? 

Wernicke’s encephalopathy is a complication of alcoholism and malnutrition resulting in thiamine deficiency.

It usually presents with characteristic mental changes of gross confusion, ataxia, extraocular movement abnormalities, and other signs of brain stem dysfunction.

The brain stem signs can be readily reversed by parenteral thiamine therapy, but the confusional state may resolve more slowly.

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