1Department of Neurology, University of Conakry, Guinea.
2Department of Anesthesia Resuscitation, University of Conakry, Guinea.
Georgian Med News. 2023 Jan(334):142-146.
In sub-Saharan Africa, the COVID-19 pandemic has caused severe malnutrition in elderly populations with the appearance of vitamin deficiencies, in particular thiamine responsible for Gayet Wernicke's encephalopathy (EGW). We present a series of six (6) patients hospitalized in the Neurology Department of the CHU Ignace Deen for the management of a brain syndrome with vigilance disorders after recovery from COVID-19, including oculomotor disorders, motor incoordination on a course of severe weight loss. The six patients underwent an evaluation of malnutrition by determining the WHO body mass index, the Detsky index, the serum albumin assay, the thiamine assay and a neuroradiological assessment (MRI) and an electroencephalogram (EEG) examination although this does not seem necessary for diagnosis. Study of nutritional status: weight loss greater than 5%, patients in Desky group B and C, plasma albumin<30 g/l, lowered thiamine and MRI neuroradiological data: by the existence of hypersignals in certain regions of the neocortex, certain gray nuclei, the mammillary bodies the thalamic nuclei close to the wall of the 3rd ventricle and the regions bordering the 4th ventricle sign Gayet Wernicke's encephalopathy syndrome. This study shows a stereotyped clinical, biological, neuroradiological and evolutionary profile of Gayet Wernicke's encephalopathy in elderly subjects recovered from Covid-19 with proven malnutrition. These results are useful for the therapeutic and prognostic discussion.
在撒哈拉以南非洲,COVID-19 大流行导致老年人群体出现严重营养不良,表现为维生素缺乏症,特别是负责引起盖耶特-韦尼克脑病(EGW)的硫胺素。我们介绍了一组 6 例患者,他们因 COVID-19 康复后出现警觉障碍性脑综合征而在 CHU Ignace Deen 神经病科住院治疗,其中包括眼球运动障碍、运动协调障碍和严重体重减轻的过程。6 例患者接受了营养不良评估,包括测定世界卫生组织体重指数、Detsky 指数、血清白蛋白测定、硫胺素测定以及神经影像学评估(MRI)和脑电图(EEG)检查,尽管这对于诊断似乎并非必要。营养状况研究:体重减轻>5%,Desky 组 B 和 C 的患者,血浆白蛋白<30g/L,硫胺素降低,MRI 神经影像学数据:由于新皮质、某些灰质核、乳头部、靠近第三脑室壁的丘脑核以及毗邻第四脑室的区域存在高信号,表明存在盖耶特-韦尼克脑病综合征。这项研究显示了 COVID-19 康复后老年患者中存在一种刻板的临床、生物学、神经影像学和进化特征明确的盖耶特-韦尼克脑病,并伴有营养不良。这些结果对于治疗和预后讨论具有重要意义。