Sars-Covid-19 Triggered Wernicke’s Encephalopathy (Clinical Case)

Abstract

Patient P., born in 1956, was found by relatives in a state of confused consciousness, an act of involuntary urination and defecation, numbness and weakening of the strength of both lower limbs were recorded. He was taken by ambulance to the reception room of the Regional Clinical Center of Neurosurgery and Neurology. The following concomitant diseases are known from the life anamnesis: Atrial fibrillation, gout, hypertension and type II non-insulin-dependent diabetes mellitus. Objective status: general condition of medium severity, tophuses of small joints of hands and feet, knee and elbow joints. Pronounced deformity of hands and feet due to gouty lesions. Heart tones are weakened. Breath sounds are weakened. The abdomen is soft, not painful on palpation. Glasgow coma scale 14-15 points. Consciousness is confused, disoriented in time, space and own person. To clarify the diagnosis, clinical and laboratory and instrumental diagnostic methods were used. Neurological complications, in particular, acute encephalopathy, on the background of coronavirus infection, may develop in patients with the presence of such risk factors as advanced age, cardiovascular diseases, hypertension, diabetes, gout. Most of the neurological complications in COVID-19 are probably not related to the direct penetration of the virus into the CNS, but are a trigger for the development of the pathology. Neuroimaging in such cases does not reveal pathological changes or reflects non-specific disorders.

Socio-Demographic Characteristics of Patients With Different Types of Encephalopathies

“…Currently, encephalopathy is considered as a collective concept of similar brain lesions with impaired brain function, which can be either a syndrome accompanying other diseases (secondary) or an independent nosological unit (primary) and the symptoms and clinical course of this condition can be very heterogeneous [1][2][3]. Today, there are also different approaches to the classification of encephalopathies.…”

“…На даний час, енцефалопатію розглядають як збірне поняття однотипних уражень головного мозку з порушенням його функції, яка може бути як синдромом, що супроводжує інші захворювання (вторинна), так і самостійною нозологічною одиницею (первинна), а симптоми та клінічний перебіг цього стану можуть бути дуже неоднорідними [1][2][3]. Сьогодні існують також різні підходи до класифікації енцефалопатій.…”

“…Among diseases of internal organs, liver diseases are becoming more and more common and require a mul-tidisciplinary approach to the management of patients. Autoimmune hepatitis (AIH) is an inflammatory liver disease that has autoimmune mechanisms of development and unknown etiology [3]. In addition, AIH affects patients of any age, gender, and ethnic group, but women are affected 6 times more often and have certain geographical features [4,5].…”