RESUMO
A 57-year-old man who was diagnosed with Wernicke-Korsakoff syndrome showed severe impairment of cognitive function and a craving for alcohol, even after sufficient supplementation with thiamine. After completing 10 sessions of 10 Hz repetitive transcranial magnetic stimulation (rTMS) at 100% of the resting motor threshold over the left dorsolateral prefrontal cortex, dramatic improvement in cognitive function and a reduction in craving for alcohol were noted. This is the first case report of the efficacy of a high-frequency rTMS in the treatment of Wernicke-Korsakoff syndrome.
Assuntos
Humanos , Pessoa de Meia-Idade , Cognição , Fissura , Síndrome de Korsakoff , Córtex Pré-Frontal , Tiamina , Estimulação Magnética TranscranianaRESUMO
Alcohol-induced cognitive disorder is a very severe problem in problem alcohol drinker and alcohol itself seems to be one of the main causalities in the development of senile dementia. However, the spectrum of alcohol induced cognitive disorder is quite broad, for example, it covered from alcohol-induced persistent amnestic disorder to Wernicke-Korsakoff syndrome and alcohol-induced persistent dementia. By that reason, broad spectrum of cognitive impairment by excessive alcohol drinking is regarded as alcohol related dementia. The pharmacological treatment is not well established yet in alcohol related dementia, except Wernicke-Korsakoff syndrome which is definitely related to thiamine deficiency. Therefore we introduced that some reports about the clinical efficacies by rivastigmine or donepezil trial and recent outcomes of memantine trial by authors in this review.
Assuntos
Consumo de Bebidas Alcoólicas , Doença de Alzheimer , Demência , Indanos , Síndrome de Korsakoff , Memantina , Fenilcarbamatos , Piperidinas , Rivastigmina , Tiamina , Deficiência de TiaminaRESUMO
PURPOSE: The authors hereby describe a case of Wernicke-Korsakoff syndrome with accompanying ocular findings that is caused by hyperernesis gravidarum. METHODS: We experienced a 27-year-old female at 12 weeks of pregnancy, who visited our clinic because of weight loss, gait disturbance, decreased mentality and dizziness after prolonged vomiting for 2 months. Neurological examination demonstrated ataxia of gait and loss of orientation. Ophthalmologic examination showed decreased visual acuity, upbeat nystagmus, diplopia and retinal hemorrhage. RESULTS: We report a relatively rare case of Wernicke-Korsakoff syndrome with ophthalmic symptoms induced by hyperemesis gravidarum. CONCLUSIONS: If a pregnant women has symptoms of severe vomiting along with other ocular findings such as retinal hemorrhage or restricted extraocular movement, one must suspect the diagnosis of Wernicke-Korsakoff syndrome, and should start appropriate treatment immediately.
Assuntos
Gravidez , Humanos , Feminino , Adulto , Transtornos da Visão/etiologia , Complicações na Gravidez , Síndrome de Korsakoff/etiologia , Hiperêmese Gravídica , Oftalmopatias/etiologiaRESUMO
Hypermesis gravidarum is a complication defined as vomiting severe enough to require hospital admission during early pregnancy. Thiamine deficiency is known to lead to certain neurological seguelae including Wernicke-Korsakoff syndrome. Wernicke's encephalopathy is an illness of acute onset characterized by global confusion, paralysis of eye ball movements, and gate ataxia due to a deficiency of thiamine. The immediate administration of thiamine prevents progression of the disease and reverses brain lesions that have not yet progressed to the point of fixed structural change. We have experienced a case of Wernicke-Korsakoff syndrome associated with hyperemesis gravidarum, which seemed to be developed by prolonged thiamine-free fluid therapy. We emphasize the need for thiamine supplementation in hyperemesis gravidarum patients.
Assuntos
Feminino , Humanos , Gravidez , Ataxia , Encéfalo , Hidratação , Hiperêmese Gravídica , Síndrome de Korsakoff , Paralisia , Tiamina , Deficiência de Tiamina , Vômito , Encefalopatia de WernickeRESUMO
A 24-year-old pregnant woman started to have severe hyperemesis gravidarum at 6 weeks' gestation. Six weeks later, dizziness, ataxia, visual disturbance, diplopia and confusion were developed. On admission, she presented ophthalmoplegia, nystagmus, deaeased tendon reflex, intention tremor, ataxia, confusion and memory disturbance. She was diagnosed to Wernicke-Korsakoff syndrome and 100mg of thiamine was administered intravenously daily till 28 weeks gestation and then intramuscularly. Her ocular symptns, together with neurological signs, were gradually improved. Memory disturbance slightly improved but remained at the time of delivery. The case will be presented in more details with a brief revie of literatures.
Assuntos
Feminino , Humanos , Gravidez , Adulto Jovem , Ataxia , Diplopia , Tontura , Hiperêmese Gravídica , Síndrome de Korsakoff , Memória , Oftalmoplegia , Gestantes , Reflexo de Estiramento , Tiamina , TremorRESUMO
Thiamine deficiency is known to lead to certain neurological sequelae including Wernicke-Korsakoff syndrome. Signs attributable to this condition include ataxia, ophthalmoplegia, nystagmus, and mental confusion. The prompt use of thiamine prevents progression of the disease and reverses those lesions that have not yet progressed to the point of fixed structual change. We have experienced a case of Wernicke-Korsakoff syndrome associated with hyperemesis gravidarum, which seemed to be developed by prolonged thiamine-free dextrose therapy, we emphasise the need for thiamine supplementation in hyperemesis gravidarum patient.