Aspectos clínicos e neuropatológicos da síndrome de Wernicke-Korsakoff

Zúbaran, Carlos; Fernandes, Jefferson Gomes; Martins, Fernanda; Souza, Janete Rousselet de; Machado, Rita de Cássia Alam; Cadore, Maria

doi:10.1590/s0034-89101996000600015

Cited by 18 publications

(16 citation statements)

References 47 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…vomiting duration) was higher in those with incomplete recovery as compared with those experiencing a complete remission (estimation of vomiting duration 37 versus 8.7 days). Overall, these results confirm that an early treatment can rapidly improve the clinical conditions (Sechi & Serra, ) and that late interventions entail the risk of long‐term damage and even irreversible sequelae (Chaves, Faintuch, Kahwage, & Alencar, ; Seehra et al, ; Zubaran et al, ). Thus, thiamine supplementation should be never delayed (i.e.…”

Section: Discussionsupporting

confidence: 64%

Wernicke Encephalopathy in Subjects Undergoing Restrictive Weight Loss Surgery: A Systematic Review of Literature Data

Milone

Minno

Lupoli

et al. 2014

Euro Eating Disorders Rev

View full text Add to dashboard Cite

The use of weight loss surgery is progressively increasing, and in recent years, restrictive bariatric surgery procedures have been more often used. Although thought to be associated with a lower incidence of post-operative side effects than malabsorpitive surgery, some cases of micronutrients deficiency have been reported because of an acquired thiamine deficiency; in this clinical setting, some cases of Wernicke encephalopathy (WE) have been described. Major determinants and predictors of this major neurological complication are currently unknown. The aim of this systematic review was to analyse literature data in order to address this issue. The main result of our systematic review was that persistent vomiting is the major determinant of WE in patients undergoing restrictive weight loss surgery. In addition, early thiamine supplementation can rapidly improve the clinical conditions, avoiding permanent deficiencies. On the other hand, given the wide variability of clinical and demographic characteristics, definite prognostic factors of WE occurrence and of clinical outcome cannot be identified. In conclusion, although our results are suggestive, further ad hoc prospective studies evaluating changes in micronutrients levels according to different types of surgery are needed.

show abstract

Section: Discussionsupporting

confidence: 64%

Wernicke Encephalopathy in Subjects Undergoing Restrictive Weight Loss Surgery: A Systematic Review of Literature Data

Milone

Minno

Lupoli

et al. 2014

Euro Eating Disorders Rev

View full text Add to dashboard Cite

show abstract

“…Os sinais radiológicos da síndrome correspodem à atrofia de estruturas cerebrais incluindo corpos mamilares, tálamo e espaço periventricular. Os hemisférios cerebelares também são comprometidos, vermis anterior e superior e ponte, contribuindo ainda mais para o desequilíbrio 27 . O atual estudo apresentou 3 casos da Síndrome de Wernicke-Korsakoff e em apenas um deles foi relatada atrofia cerebral e cerebelar.…”

Section: Resultsunclassified

Sinais e Sintomas Vestibulares e Doenças do Sistema Nervoso Central

Ganança¹,

Fukujima²,

Duarte³

et al. 2017

RECES

View full text Add to dashboard Cite

O desafio diante de pacientes com sintomas vestibulares (SV) é a distinção entre o acometimento do sistema vestibular periférico ou do sistema nervoso central (SNC), pois se tratam de etiologias com gravidade, prognóstico e conduta terapêutica diferentes. Descrever as características clínicas, vecto eletronistagmo gráficas e achados de exames de imagem de pacientes com SV e acometimento de SNC. Estudo retrospectivo, em que foram analisados os prontuários de todos os pacientes com SV atendidos em um ambulatório de Otoneurologia em um período de dez anos. Foram incluídos apenas aqueles com sintomas vestibulares devido a diagnóstico etiológico de doenças em SNC. Foram avaliadas as características clínicas, os achados à vectoeletronistagmografia (VENG) e aos exames de imagem. Foram avaliados 3826 prontuários elegíveis, destes 87 (2,23%) casos foram incluídos. A maioria, 77% foi do gênero feminino, com idade média de 60,88 ± 19,34. A etiologia vascular foi a mais prevalente (45,9%). Quanto aos achados à VENG, 23% apresentaram achados patognomônicos de alterações em SNC, 48,3% achados sugestivos e 19,5% foram exames normais. Em 53 casos (60,9%) houve alterações em exames de imagem. Os SV podem ser a única manifestação de doenças em SNC. Quando ocorrem neste caso, são mais prevalentes em indivíduos na sexta década de vida e no gênero feminino. A VENG e os exames de imagem podem apresentar alterações de acometimento de SNC, mas não excluem este diagnóstico, quando normais, sendo imprescindível considerá-los em conjunto com a avaliação clínica do paciente.

show abstract

“…In chronic cases, neuronal loss is more accentuated, in large part in the connections between the temporal lobe, the structures of the diencephalon and the frontal lobe, disrupting the formation of declarative memories and the performance of executive functions, which explains the behavioural changes reported in the literature (Oscar-Berman, Kirkley, Gansler, & Couture, 2004;Vann & Aggleton, 2004) Thiamine replacement is the most frequently used pharmacological intervention. However, psychological decline is almost always inevitable because the cognitive changes result from the interaction between alcohol neurotoxicity, thiamine deficiency and personal susceptibility (Zubaran et al, 1996). In the majority of cases, thiamine replacement leads to recovery of the general clinical status and improvement of the state of alertness and volition.…”

mentioning

confidence: 99%

“…In addition to the cognitive and behavioural symptoms, WKS may further cause psychiatric symptoms such as confabulation, paranoid delusions, auditory hallucinations and cognitive disorders (Kopelman, Thomson, Guerrini, & Marshall, 2009;Zubaran et al, 1996). This complex manifestation of symptoms demands the intervention of an interdisciplinary team, composed of psychiatrists, neurologists and psychologists.…”

mentioning

confidence: 99%

Neuropsychological Intervention in a Case of Korsakoff's Amnesia

et al. 2011

View full text Add to dashboard Cite

T he cognitive symptoms that characterise the Wernicke-Korsakoff's syndrome include anterograde amnesia, confabulation, temporal-spatial disorientation, severe apathy, poor awareness of one's own mental state and changes in executive functions. Such deficits may persist even after the clinical profile stabilises. There are no studies that report an intervention after the acute phase, possibly due to the complexity of these cases. This study provides a descriptive analysis of neuropsychological rehabilitation concomitant to the neurological and psychiatric treatment of a woman who presented the symptoms described by Korsakoff. The intervention focused on reducing the impact caused by the cognitive and behavioural sequelae in the patient's daily life. It described a 25-week neuropsychological program, providing education and compensatory strategies for the patient, and also orientation and support from 2 professional caregivers and family members. Quantitative and qualitative measures were used to evaluate the effect of the intervention on memory efficacy, emotional state and social participation. Both caregivers reported a decrease in the frequency of memory lapses after treatment. Positive changes were also seen in self-care, activities at home, decision-making and participation in social activities. It is concluded that this case achieved results through the collaboration between members of an interdisciplinary team and caregivers providing daily support.

show abstract

Aspectos clínicos e neuropatológicos da síndrome de Wernicke-Korsakoff

Cited by 18 publications

References 47 publications

Wernicke Encephalopathy in Subjects Undergoing Restrictive Weight Loss Surgery: A Systematic Review of Literature Data

Wernicke Encephalopathy in Subjects Undergoing Restrictive Weight Loss Surgery: A Systematic Review of Literature Data

Sinais e Sintomas Vestibulares e Doenças do Sistema Nervoso Central

Neuropsychological Intervention in a Case of Korsakoff's Amnesia

Contact Info

Product

Resources

About