Harper C G, Giles M, Finlay-Jones R
J Neurol Neurosurg Psychiatry. 1986 Apr;49(4):341-5. doi: 10.1136/jnnp.49.4.341.
A recent necropsy study has shown that 80% of patients with the Wernicke-Korsakoff syndrome were not diagnosed as such during life. Review of the clinical signs of these cases revealed that only 16% had the classical clinical triad and 19% had no documented clinical signs. The incidence of clinical signs in this and other retrospective pathological studies is very different from that of prospective clinical studies. This discrepancy may relate to "missed" clinical signs but the magnitude of the difference suggests that at least some cases of the Wernicke-Korsakoff syndrome may be the end result of repeated subclinical episodes of vitamin B1 deficiency. In order to make the diagnosis, clinicians must maintain a high index of suspicion in the "at risk" group of patients, particularly alcoholics. Investigations of thiamine status may be helpful and if the diagnosis is suspected, parenteral thiamine should be given.
最近的一项尸检研究表明，80%的韦尼克-科尔萨科夫综合征患者在生前未被诊断为此病。对这些病例的临床体征进行回顾发现，只有16%的患者具有典型的临床三联征，19%的患者没有记录在案的临床体征。该研究以及其他回顾性病理学研究中临床体征的发生率与前瞻性临床研究有很大不同。这种差异可能与“漏诊”的临床体征有关，但差异程度表明，至少部分韦尼克-科尔萨科夫综合征病例可能是维生素B1缺乏反复亚临床发作的最终结果。为了做出诊断，临床医生必须对“高危”患者群体，尤其是酗酒者保持高度的怀疑指数。硫胺素状态的检查可能会有所帮助，如果怀疑诊断，应给予肠胃外硫胺素。
