Başoğlu M, Yetimalar Y, Gürgör N, Büyükçatalbaş S, Kurt T, Seçil Y, Yeniocak A
Neurology Department, Atatürk Training and Research Hospital, Izmir, Turkey.
Eur J Neurol. 2006 Oct;13(10):1089-97. doi: 10.1111/j.1468-1331.2006.01531.x.
We investigated neurological findings in 41 prisoners (mean age: 28.6) who participated in a hunger strike between 2000 and 2002. All cases were evaluated using neuropsychological, neuroradiological, and electrophysiological methods. The total duration of fasting ranged from 130 to 324 days (mean 199 days). All cases had 200-600 mg/day thiamine orally for 60-294 days (mean 156) during the hunger strike, and had neurological findings consistent with Wernicke-Korsakoff syndrome. All 41 patients exhibited altered consciousness which lasted from 3 to 31 days. All patients also presented gaze-evoked horizontal nystagmus and truncal ataxia. Paralysis of lateral rectus muscles was found in 14. Amnesia was apparent in all cases. Abnormal nerve conduction study parameters were not found in the patient group, but the amplitude of compound muscle action potential of the median and fibular nerves and sensory nerve action potential amplitude of the sural nerve were lower than the control group, and distal motor latency of the posterior tibial nerve was significantly prolonged as compared with the control group. The latency of visual evoked potential was prolonged in 22 cases. Somatosensory evoked potential (P37) was prolonged but not statistically significant. Our most significant finding was that the effect of hunger was more prominent on the central nervous system than on the neuromuscular system, despite the fact that all patients were taking thiamine. In our opinion, partial recovery of neurological, and neurocognitive signs in prolonged hunger could be a result of permanent neurological injury.
我们调查了41名在2000年至2002年期间参加绝食抗议的囚犯（平均年龄：28.6岁）的神经学表现。所有病例均采用神经心理学、神经放射学和电生理学方法进行评估。禁食总时长为130至324天（平均199天）。所有病例在绝食期间口服硫胺素200 - 600毫克/天，持续60 - 294天（平均156天），并出现了与韦尼克 - 科尔萨科夫综合征相符的神经学表现。所有41例患者均出现意识改变，持续3至31天。所有患者还表现出凝视诱发的水平眼球震颤和躯干共济失调。14例患者发现外直肌麻痹。所有病例均有明显的失忆症状。患者组未发现神经传导研究参数异常，但正中神经和腓神经的复合肌肉动作电位幅度以及腓肠神经的感觉神经动作电位幅度低于对照组，与对照组相比，胫后神经的远端运动潜伏期显著延长。22例患者视觉诱发电位潜伏期延长。体感诱发电位（P37）延长，但无统计学意义。我们最显著的发现是，尽管所有患者都服用了硫胺素，但饥饿对中枢神经系统的影响比对神经肌肉系统更为突出。我们认为，长期饥饿中神经和神经认知体征的部分恢复可能是永久性神经损伤的结果。
