Citation

Güngör Doğan, Uzun Altiokka G, Türker F, Saka B, Bilgiç B, Kocasoy Orhan E. Noro Psikiyatr Ars 2018; 55(4): 307-314.

Copyright

(Copyright © 2018, Turk Noro-Psikiyatri Derneginin Yayin Organidir)

DOI

10.29399/npa.23010

PMID

unavailable

Abstract

INTRODUCTION: Wernicke's encephalopathy (WE) is an underdiagnosed neuropsychiatric disorder especially in non-alcoholic groups that causes morbidity-mortality if diagnosis is delayed. Korsakoff syndrome is a chronic consequence of this condition characterized by persistent memory impairment. In this study we present a series of non-alcoholic patients with WE. The purpose of this study was to analyze the predisposing factors in non-alcoholic patients with WE and emphasize the importance of early diagnosis and treatment with thiamine supplementation.

METHODS: The clinical records of 6 cases with WE followed by gastrointestinal tract disease and/or surgery who were admitted to our Medical Faculty between 2012 and 2014 were retrospectively reviewed.

RESULTS: The study included 3 men and 3 women in the age range of 24 to 55. All patients had gastrointestinal tract diseases and/or had undergone gastrointestinal surgeries, and were non-alcoholic. Vomiting, weight loss, and parenteral nutrition were the frequent precipitating factors. The classic triad of mental impairment, oculomotor alterations and gait ataxia was present in 4 of the 6 patients. Magnetic Resonance Imaging showed typical signal alterations in the medial thalami, mammillary bodies and the periaqueductal region of patients in various degrees. Clinical improvement was seen in each patient after thiamine supplementation.

DISCUSSION: Physicians should be aware of the predisposing factors and symptoms to prevent or optimize the management of this potentially devastating disease. Thiamine supplementation should be considered in patients with gastrointestinal tract diseases or those who have undergone surgery. © 2017 by Turkish Association of Neuropsychiatry.

Language: en

Keywords

adult; human; female; male; abdominal pain; physical activity; suicide attempt; case study; vomiting; retrospective study; clinical article; hospital admission; early diagnosis; human tissue; middle aged; treatment indication; nuclear magnetic resonance imaging; confusion; nausea; quadriplegia; gastrointestinal disease; nystagmus; pylorus stenosis; paresthesia; antiemetic agent; parenteral nutrition; thiamine; confabulation; ulcerative colitis; treatment response; virus DNA; virus load; neurologic examination; cytomegalovirus infection; Article; hyporeflexia; diet supplementation; electromyography; muscle strength; bloating; young adult; Wernicke encephalopathy; bloody diarrhea; surgical infection; ganciclovir; small intestine resection; areflexia; hemicolectomy; gastric bypass surgery; acute inflammatory demyelinating polyneuropathy; ataxic gait; body weight loss; electroencephalography monitoring; endoscopic biopsy; Korsakoff syndrome; mammillary body; polyposis; Thiamine deficiency; Thiamine supplementation; Wernicke-Korsakoff syndrome; Wernicke’s encephalopathy