Wallis W E, Willoughby E, Baker P
Lancet. 1978 Aug 19;2(8086):400-1. doi: 10.1016/s0140-6736(78)91867-6.
Four comatose patients were found to have the Wernicke-Krosakoff syndrome. All had a history of alcoholism, previous alcoholic neurological disease, and poor nutrition. Intravenous or nasogastric tube feeding without vitamin supplements precipitated coma in three. Examination showed a diffuse encephalopathy with intact pupillary light reflexes, no focal neurological signs, and absent doll's eye and caloric responses. The tendon reflexes were uniformly absent. Two patients were hypothermic and one was hypotensive. Although the level of consciousness improved in all after parenteral thiamine, three died and one was left disabled. The Wernicke-Korsakoff syndrome merits wider recognition as a cause of coma and empirical treatment with thiamine in cases of coma of unknown cause is recommended.
发现四名昏迷患者患有韦尼克-科萨科夫综合征。他们均有酗酒史、既往酒精性神经疾病史以及营养不良。三名患者在未补充维生素的情况下通过静脉或鼻饲管喂食诱发了昏迷。检查显示为弥漫性脑病，瞳孔对光反射正常，无局灶性神经体征，玩偶眼反射和冷热反应消失。腱反射均消失。两名患者体温过低，一名患者血压过低。尽管所有患者在胃肠外给予硫胺素后意识水平均有改善，但三名患者死亡，一名患者致残。韦尼克-科萨科夫综合征作为昏迷的一个病因应得到更广泛的认识，对于病因不明的昏迷病例，建议经验性使用硫胺素进行治疗。
