Wernicke-Korsakoff Syndrome or ’Wet Brain’
Background:
In 1881, Carl Wernicke first described an illness that consisted of
paralysis of eye movements, inability to coordinate voluntary muscle
movements, and mental confusion in 3 patients. The patients, 2 males
with alcoholism with progression to coma and death. Wernicke detected
holes and bleeding affecting the grey matter in some parts of the brain.
S.S. Korsakoff,
a Russian psychiatrist, described the disturbance of memory in the
course of long-term alcoholism in a series of articles from 1887-1891.
In 1897, Murawieff first postulated that a single cause of a disease was responsible for both syndromes – Wernicke syndrome and Korsakoff syndrome. Or, in common terms – ‘wet brain’.
The
term Wernicke encephalopathy is used to describe the symptom complex of
paralysis of some nerves of the eye, inability to coordinate voluntary
muscle movements, and an acute confusional state. If persistent learning and memory deficits are present, the symptom complex is termed Wernicke-Korsakoff syndrome.
Cause; A lack of thiamine (vitamin B-1) is responsible for the symptom manifested in Wernicke-Korsakoff syndrome, and any condition resulting in a poor nutritional state places drinkers at risk.
Heavy, long-term alcohol use is the most common association with Wernicke-Korsakoff
syndrome. Alcohol interferes with active stomach juice transport, and
chronic liver disease leads to decreased activation of thiamine, as well
as a decreased capacity of the liver to store thiamine.
Statistics
* Prevalence data have come primarily from post-mortem studies, with rates of 1 to 3%.
* The rate has been found to be significantly higher in specific populations, ie,
homeless people, older people (especially those living alone or in
isolation), and psychiatric inpatients, where alcohol use and poor
nutritional states predominate.
* The death rate is 10-20%. That is if you get it you have a 10 to 20% chance of an early death.
* In general, full recovery of eye function occurs. Fine horizontal eye movement can persist in as many as 60% of cases.
* Approximately 40% of patients have complete recovery from inability to coordinate voluntary muscle movements.
* Only 20% of patients recover completely from partial loss of memory deficit.
* The rates of the disease are similar across races.
* The condition affects males slightly more frequently than it affects females.
* Age of onset is evenly distributed from 30-70 years.
Eye/visual disturbances
* Painless vision abnormalities
* Double vision
* squint
Gait abnormalities
* Wide-based, short-stepped gait
* Inability to stand or walk without assistance
Mental status changes
* Apathy, indifference, insufficient speech
* Hallucination, agitation
* Confabulation: Patient fills in gaps of memory with data that can be recalled at that moment.
Medical
Care: Wernicke encephalopathy is a medical emergency. Prompt
recognition of the symptoms and a high index of suspicion are crucial to
ensure early treatment. Intravenous thiamine (50-100 mg) is the
treatment of choice.
alcohol drugs Wernicke Korsakoff Syndrome
Functional Alcoholic?
Early
treatment can rapidly reverse the eye problems and improve inability to
coordinate voluntary muscle movements and early mental confusion, as
well as prevent development of the partial loss of memory state. In
advanced cases, where severe prolonged deficiency has led to permanent
structural brain damage, permanent thinking deficits remain.
Long-term alcohol use is the most common aetiology for Wernicke-Korsakoff
syndrome, and abstinence provides the best chance for recovery.
Referral to an alcohol recovery program should be part of the treatment
regimen.
A
balanced diet should be resumed as early as possible. Vitamin and
should be adhered to in addition to a well-balanced diet initially, and
supplementation can be tapered as the patient resumes normal intake and
demonstrates improvement.
Due
to gait abnormalities, unassisted ambulation is discouraged during the
initial phase of treatment. Patients may require physical therapy
evaluation for gait assistance. Gait abnormalities may be permanent,
depending on the severity at initial presentation and the timeliness of
therapy.
Recovering patients will require outpatient follow-up care to evaluate for continued progress or relapse.
Patients
should continue taking thiamine supplementation, as well as other
vitamins and electrolytes, until a well-balanced diet can be maintained.
Long-term supplementation may be required in patients who cannot
maintain adequate nutritional intake, whether from noncompliance or the
underlying disorder.
If you or someone you love or care about is in the grips of alcoholism, call us today for help with choosing addiction treatment options that is right for you at 07 56 066 315.
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and assessment, if needed. International clients welcome.
We also welcome enquiries from English speaking people from Asia, Europe, Africa, India and South America.
Primary
care at CWS is personalised to treat each individual using programs
that integrate mind, body and soul. CWS programs are enhanced by highly
effective group coaching and therapeutic processes as well as individual
coaching, spiritual insights, therapy and extensive aftercare
assistance.
All
clients are thoroughly assessed by a highly trained and experienced
recovery coach, registered provisional psychologist, ordained Monk,
mental health officer and certified naturopaths (including Ayurveda and
Acupuncturist). Clients may also be referred for psychometric testing
and assessment, if needed. International clients welcome.
We welcome enquiries from all English speaking people from Asia, Europe, Africa, India and South America.
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