Doğan İpek Güngör, Altiokka Güneş Uzun, Türker Fulya, Saka Bülent, Bilgiç Başar, Orhan Elif Kocasoy
Department of Neurology, İstanbul Medical Faculty, University of İstanbul, Turkey.
Department of Internal Medicine, İstanbul Medical Faculty, University of İstanbul, Turkey.
Noro Psikiyatr Ars. 2018 Dec;55(4):307-314. doi: 10.29399/npa.23010. Epub 2018 Apr 25.
Wernicke's encephalopathy (WE) is an underdiagnosed neuropsychiatric disorder especially in non-alcoholic groups that causes morbidity-mortality if diagnosis is delayed. Korsakoff syndrome is a chronic consequence of this condition characterized by persistent memory impairment. In this study we present a series of non-alcoholic patients with WE. The purpose of this study was to analyze the predisposing factors in non-alcoholic patients with WE and emphasize the importance of early diagnosis and treatment with thiamine supplementation.
The clinical records of 6 cases with WE followed by gastrointestinal tract disease and/or surgery who were admitted to our Medical Faculty between 2012 and 2014 were retrospectively reviewed.
The study included 3 men and 3 women in the age range of 24 to 55. All patients had gastrointestinal tract diseases and/or had undergone gastrointestinal surgeries, and were non-alcoholic. Vomiting, weight loss, and parenteral nutrition were the frequent precipitating factors. The classic triad of mental impairment, oculomotor alterations and gait ataxia was present in 4 of the 6 patients. Magnetic Resonance Imaging showed typical signal alterations in the medial thalami, mammillary bodies and the periaqueductal region of patients in various degrees. Clinical improvement was seen in each patient after thiamine supplementation.
Physicians should be aware of the predisposing factors and symptoms to prevent or optimize the management of this potentially devastating disease. Thiamine supplementation should be considered in patients with gastrointestinal tract diseases or those who have undergone surgery.
韦尼克脑病（WE）是一种诊断不足的神经精神疾病，尤其是在非酒精性群体中，如果诊断延迟会导致发病和死亡。科萨科夫综合征是这种疾病的慢性后果，其特征是持续的记忆障碍。在本研究中，我们报告了一系列非酒精性韦尼克脑病患者。本研究的目的是分析非酒精性韦尼克脑病患者的诱发因素，并强调早期诊断和补充硫胺素治疗的重要性。
回顾性分析2012年至2014年期间我院收治的6例伴有胃肠道疾病和/或手术史的韦尼克脑病患者的临床记录。
研究包括3名男性和3名女性，年龄在24至55岁之间。所有患者均患有胃肠道疾病和/或接受过胃肠道手术，且均为非酒精性。呕吐、体重减轻和肠外营养是常见的诱发因素。6例患者中有4例出现了精神障碍、动眼神经改变和步态共济失调的典型三联征。磁共振成像显示患者的内侧丘脑、乳头体和导水管周围区域有不同程度的典型信号改变。补充硫胺素后，每位患者的临床症状均有改善。
医生应了解诱发因素和症状，以预防或优化对这种潜在破坏性疾病的管理。对于患有胃肠道疾病或接受过手术的患者，应考虑补充硫胺素。
