Wernicke-Korsakoff Syndrome
Alcohol abuse is one of the most serious problems in public health and Wernicke-Korsakoff syndrome is one of the gravest consequences of alcoholism. Wernicke-Korsakoff syndrome can be defined as a neurological disorder due to nutritional deficiency, more specifically a deficiency of vitamin B1 or thiamine.
Thiamine plays a vital role in carbohydrate metabolism. Unremitting alcohol consumption displaces food in the diet, decreases thiamine intake and adds its own carbohydrate calories. This increases the need for thiamine for metabolizing excess glucose to produce energy for the brain.
Additionally, persistent alcohol intake decreases absorption of thiamine from the gastrointestinal tract and impairs its utilization in the cells. These may contribute to the development of thiamin deficiency. When it occurs, Wernicke-Korsakoff syndrome may develop.
This neurological syndrome can be divided into two stages, namely Wernicke's encephalopathy and Korsakoff syndrome. Wernicke disease, or Wernicke encephalopathy, is said to be an acute neurologic disorder of abrupt onset, characterized by nystagmus (involuntary oscillatory movements of the eyes), conjugate gaze palsy (an inability of both eyes to move in the same direction at the same), unsteadiness of stance and gait, confusion, and apathy (lack of spontaneous behavior). These manifestations may occur alone or in various combinations.
Korsakoff psychosis (better termed Korsakoff syndrome), refers to an abnormality of the brain, in which learning and memory are affected out of proportion to other cognitive functions. The common symptoms of this chronic syndrome include amnesia (severe loss of memory), confabulation, lack of insight, apathy, etc.
If caught early enough, Wernicke-Korsakoff syndrome is a preventable, treatable disease. Individuals with signs of Wernicke’s encephalopathy are treated with thiamine immediately. Prompt administration of thiamine reverses the symptoms and prevents amnesia from developing.
Thiamine is administered intravenously or directly into the digestive system. Unfortunately, thiamine is less effective in the chronic phase of the condition. In some cases, drug therapy is also recommended. Recent reports suggest that donepezil and rivastigmine, drugs used to treat Alzheimer's disease, may improve memory in people with Wernicke-Korsakoff syndrome.
Wernicke-Korsakoff syndrome can be prevented with a nutritious diet containing sufficient thiamine. Because severe chronic alcoholism is the most common cause of thiamine deficiency, treatment of alcohol dependence is extremely important. Without treatment, these disorders can be disabling and life-threatening Thus, it is rightly said that “prevention is better than cure.”
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