Oudman Erik, Wijnia Jan W, Bidesie Janice, Al-Hassaan Zyneb, Laenen Sascha, Jong-Tjien-Fa Amy V
Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands.
Slingedael Korsakoff Expertise Center, Lelie Care Group, 3086 EZ Rotterdam, The Netherlands.
J Clin Med. 2023 Apr 17;12(8):2901. doi: 10.3390/jcm12082901.
Wernicke encephalopathy (WE), a neurological emergency commonly associated with alcohol use disorder, results from a severe deficiency of vitamin B1. If left untreated, patients either succumb to the illness or develop chronic Korsakoff's syndrome (KS). Recently, an increasing number of nonalcoholic WE case studies have been published, highlighting a lack of understanding of malnutrition-related disorders among high-functioning patients. We present the case of a 26 year old female who developed life-threatening WE after COVID-19-complicated obesity surgery. She experienced the full triad of WE symptoms, including eye-movement disorders, delirium, and ataxia, and suffered for over 70 days before receiving her initial WE diagnosis. Late treatment resulted in progression of WE symptoms. Despite the severity, the patient achieved remission of some of the symptoms in the post-acute phase due to prolonged parenteral thiamine injections and intensive specialized rehabilitation designed for young traumatic brain injury (TBI) patients. The rehabilitation resulted in gradual remission of amnesia symptomatology, mainly increasing her autonomy. The late recognition of this case highlights the importance of early diagnosis and prompt, targeted intervention in the management of nonalcoholic WE, as well as underscores the potential for positive outcomes after delayed treatment through intensive cognitive rehabilitation in specialized treatment centers.
韦尼克脑病（WE）是一种常与酒精使用障碍相关的神经急症，由维生素B1严重缺乏所致。若不治疗，患者要么死于该病，要么发展为慢性科萨科夫综合征（KS）。最近，越来越多非酒精性韦尼克脑病的病例研究被发表，凸显了对功能良好患者中与营养不良相关疾病的认识不足。我们报告一例26岁女性病例，该患者在新冠病毒感染相关肥胖手术后发生危及生命的韦尼克脑病。她出现了韦尼克脑病的全部三联征症状，包括眼球运动障碍、谵妄和共济失调，在首次被诊断为韦尼克脑病之前遭受病痛折磨超过70天。延迟治疗导致韦尼克脑病症状进展。尽管病情严重，但由于长期胃肠外注射硫胺素以及为年轻创伤性脑损伤（TBI）患者设计的强化专科康复治疗，患者在急性期后某些症状得到缓解。康复治疗使失忆症状逐渐缓解，主要是增强了她的自主性。该病例的延迟诊断凸显了非酒精性韦尼克脑病管理中早期诊断和及时、有针对性干预的重要性，同时也强调了在专科治疗中心通过强化认知康复进行延迟治疗后取得积极结果的可能性。
