Wernicke encephalopathy is an acute, reversible condition that is caused by severe thiamine deficiency. This condition is most commonly seen in alcohol abusers. The classic triad of symptoms is encephalopathy, oculomotor dysfunction, and gait ataxia, although all 3 features are only present in one-third of patients. Korsakoff syndrome is a severe and late neuropsychiatric manifestation of Wernicke encephalopathy Encephalopathy Hyper-IgM Syndrome. Korsakoff syndrome presents with personality changes, anterograde and retrograde amnesia, and confabulation. Some of these changes are irreversible. Both Wernicke encephalopathy Encephalopathy Hyper-IgM Syndrome and Korsakoff syndrome may be diagnosed clinically. Treatment includes absolute abstinence from alcohol and thiamine Thiamine Also known as thiamine or thiamin, it is a vitamin C12H17N4OSCl of the vitamin B complex that is essential to normal metabolism and nerve function and is widespread in plants and animals Water-soluble Vitamins and their Deficiencies supplementation.
Last updated: 24 Jan, 2022
Wernicke encephalopathy Encephalopathy Hyper-IgM Syndrome and Korsakoff syndrome are neurologic conditions that arise because of thiamine Thiamine Also known as thiamine or thiamin, it is a vitamin C12H17N4OSCl of the vitamin B complex that is essential to normal metabolism and nerve function and is widespread in plants and animals Water-soluble Vitamins and their Deficiencies (vitamin B1) deficiency. Wernicke encephalopathy Encephalopathy Hyper-IgM Syndrome is an acute, reversible condition. Korsakoff syndrome is an irreversible syndrome that is caused by more severe or prolonged thiamine Thiamine Also known as thiamine or thiamin, it is a vitamin C12H17N4OSCl of the vitamin B complex that is essential to normal metabolism and nerve function and is widespread in plants and animals Water-soluble Vitamins and their Deficiencies deficiency and occurs after incomplete recovery from Wernicke encephalopathy Encephalopathy Hyper-IgM Syndrome.
Wernicke encephalopathy Encephalopathy Hyper-IgM Syndrome and Korsakoff syndrome are caused by a severe deficiency of thiamine Thiamine Also known as thiamine or thiamin, it is a vitamin C12H17N4OSCl of the vitamin B complex that is essential to normal metabolism and nerve function and is widespread in plants and animals Water-soluble Vitamins and their Deficiencies. This deficiency is most commonly due to:
Molecular structure of
thiamine
Thiamine
Also known as thiamine or thiamin, it is a vitamin C12H17N4OSCl of the vitamin B complex that is essential to normal metabolism and nerve function and is widespread in plants and animals
Water-soluble Vitamins and their Deficiencies:
Levels are deficient in Wernicke
encephalopathy
Encephalopathy
Hyper-IgM Syndrome and Korsakoff syndrome
The diencephalon Diencephalon The paired caudal parts of the prosencephalon from which the thalamus; hypothalamus; epithalamus; and subthalamus are derived. Development of the Nervous System and Face is strongly impacted in Wernicke encephalopathy Encephalopathy Hyper-IgM Syndrome.
Image: “ Diencephalon Diencephalon The paired caudal parts of the prosencephalon from which the thalamus; hypothalamus; epithalamus; and subthalamus are derived. Development of the Nervous System and Face” by Arcadian. License: Public Domain, edited by Lecturio.Wernicke encephalopathy Encephalopathy Hyper-IgM Syndrome and Korsakoff syndrome are primarily clinical diagnoses.
Korsakoff syndrome:
Restricted
diffusion
Diffusion
The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space. Diffusion, especially facilitated diffusion, is a major mechanism of biological transport.
Peritoneal Dialysis and Hemodialysis in the thalami is a classic finding.
Wernicke’s
encephalopathy
Encephalopathy
Hyper-IgM Syndrome:
MRI of head demonstrating periventricular hyperintensities at the medial thalami bilaterally, consistent with Wernicke’s
encephalopathy
Encephalopathy
Hyper-IgM Syndrome. Orange arrows identifying areas of abnormality.
In addition to treatment of the presenting encephalopathy Encephalopathy Hyper-IgM Syndrome, the clinician Clinician A physician, nurse practitioner, physician assistant, or another health professional who is directly involved in patient care and has a professional relationship with patients. Clinician–Patient Relationship should also have a high clinical suspicion for acute alcohol intoxication Alcohol intoxication An acute brain syndrome which results from the excessive ingestion of ethanol or alcoholic beverages. Alcohol Use Disorder, hepatic encephalopathy Encephalopathy Hyper-IgM Syndrome, alcohol withdrawal Alcohol withdrawal With chronic alcohol use, body increases activity of excitatory receptors (e.g., glutamate) while decreasing activation of inhibitory receptors (e.g., GABA). Cessation of alcohol use leads to unchecked glutamate activation, presenting as withdrawal. Alcohol Use Disorder syndrome, and alcoholic Alcoholic Persons who have a history of physical or psychological dependence on ethanol. Mallory-Weiss Syndrome (Mallory-Weiss Tear) ketoacidosis Ketoacidosis A life-threatening complication of diabetes mellitus, primarily of type 1 diabetes mellitus with severe insulin deficiency and extreme hyperglycemia. It is characterized by ketosis; dehydration; and depressed consciousness leading to coma. Metabolic Acidosis.
Treatment should be prompt because memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment deficits may be irreversible.
Korsakoff syndrome is serious and may require a high level of care for life, as memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment deficits are often permanent.