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[韦尼克-科尔萨科夫综合征:临床症状、病理生理学及治疗方法]

[Wernicke-Korsakow syndrome: clinical aspects, pathophysiology and therapeutic approaches].

作者信息

Preuss U W, Soyka M

机构信息

Psychiatrische Klinik und Poliklink, Ludwig-Maximilians-Universität München.

出版信息

Fortschr Neurol Psychiatr. 1997 Sep;65(9):413-20. doi: 10.1055/s-2007-996346.

Abstract

In ICD-10 or DSM IV, the Wernicke-Korsakow Syndrome (WKS) is mentioned among the criteria for the alcohol amnestic disorder. Rarely seen in clinical practice, the Wernicke-Korsakow Syndrome is important in differential diagnosis of amnestic syndromes, because life-threatening conditions can occur. A specific treatment is available for the acute form of Wernicke encephalopathy, in many cases a Wernicke encephalopathy shows a progression to the Korsakow-Syndrome, which is the chronic form of this disease. The aim of this article is to review recent developments in clinical, etiological and pathophysiological research of WKS. The role of thiamin-dependent enzymes like transketolase and the importance of the NMDA (N-Methyl-D-Aspartate) System is discussed. New trends in diagnostics are shown, as are differential diagnosis and epidemiology. Finally, the rarely investigated drug therapy of the Korsakow syndrome with clonidine and fluvoxamine is reviewed.

摘要

在《国际疾病分类第10版》(ICD - 10)或《精神疾病诊断与统计手册第4版》(DSM IV)中,韦尼克 - 科萨科夫综合征(WKS)被列入酒精所致遗忘障碍的诊断标准之中。韦尼克 - 科萨科夫综合征在临床实践中较为罕见,但在遗忘综合征的鉴别诊断中很重要,因为可能会出现危及生命的情况。针对韦尼克脑病的急性形式有特定的治疗方法,在许多情况下,韦尼克脑病会进展为科萨科夫综合征,即该疾病的慢性形式。本文旨在综述韦尼克 - 科萨科夫综合征在临床、病因学和病理生理学研究方面的最新进展。讨论了转酮醇酶等硫胺素依赖性酶的作用以及N - 甲基 - D - 天冬氨酸(NMDA)系统的重要性。展示了诊断方面的新趋势、鉴别诊断和流行病学情况。最后,综述了用可乐定和氟伏沙明对科萨科夫综合征进行的鲜有研究的药物治疗。

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