A Case of Chronic Wernicke’s Encephalopathy: A Neuropsychological Study

Abstract

A 54-year-old woman was referred to our Korsakoff Center because of extensive cognitive problems following acute Wernicke’s encephalopathy (WE). She had a relatively short history of alcohol abuse and was found lying on the floor in her home by her son. After 5 days without treatment, she was diagnosed with WE in a general hospital. During the course of the disease, minimal change to the acute situation occurred, with chronic confusion, attention deficits, and incoherent behavior symptoms most notable unlike classical Korsakoff’s syndrome. Neuropsychological assessment after 4 and 16 months after admission to the hospital revealed global cognitive decline, with striking impairments in attentional, executive, and memory functions. The present case study suggests that the state of confusion and the neuropsychological symptoms in WE can become chronic in case of very late treatment. We therefore recommend that confused alcoholics should receive appropriate parenteral thiamine according to the current clinical standards.

Procedural Learning and Memory Rehabilitation in Korsakoff’s Syndrome - a Review of the Literature

“…Strikingly, in the acute phase memory problems are not necessarily present but will develop over the course of the syndrome (Isenberg-Grzeda et al 2012 ). Severe cognitive problems are often the direct consequence of undertreated thiamine deficiency (Oscar-Berman et al 1982 ; Sechi and Serra 2007 ; Oudman et al 2014 ). In the chronic phase of KS, cognitive problems do not respond to thiamine therapy any more (Smith and Hilman 1999 ).…”

Young Nonalcoholic Wernicke Encephalopathy Patient Achieves Remission Following Prolonged Thiamine Treatment and Cognitive Rehabilitation

“…Prodromal, acute, and late symptomatology of WE was missed, leading to a long treatment delay with end-stage characteristics of WE. While such a severe course of WE can lead to severe chronic Korsakoff's syndrome or even chronic WE [42,43], this patient showed remission of acute symptoms through extensive physical and neuropsychological rehabilitation and prolonged thiamine treatment. The present study highlights the importance of regular vitamin checks after obesity surgery.…”

Postseizure aphasia in Wernicke's encephalopathy: a case report and review of literature

“…It should be noted that WE, while more easily recognized in alcohol abuse, can also be caused by anorexia nervosa 2 and bariatric surgery. 3 Classically, WE is characterized as ataxia, confusion, and nystagmus. An alternative clinical definition considers WE if two of the following conditions are met: dietary deficiencies, oculomotor dysfunction, and either altered mental status or mild memory dysfunction.…”