Wernicke-Korsakoff syndrome diagnostics and rehabilitation in the post-acute phase

Oudman, Erik; Oey, Misha J.; Batjes, Deirdre; Dam, Mirjam van; Dorp, Maaike van; Postma, Albert; Wijnia, Jan W.

doi:10.1016/j.addicn.2022.100043

Cited by 9 publications

(9 citation statements)

References 46 publications

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“…25 Errorless learning, which utilizes vanishing prompts and cues to promote retention (rather than trial-and-error learning) has been reasonably efficacious in small trials. 19 For example, in one study Korsakoff's syndrome patients were able to utilize a washing machine after eight training sessions, 24 and in another trial patients increased their daily living and housekeeping chores. 26,27 Should her deficits persist long-term, we hope our patient will respond positively to these and other therapies.…”

Section: Neurology Clinical Questionmentioning

confidence: 99%

“…However, the precise pattern of imaging abnormalities seen in this patient were classic (and generally regarded as pathognomonic) for WE, and not characteristic of ADEM, multiple sclerosis, or stroke. MRI imaging has a sensitivity of 53% and specificity of 93% for WE (although these numbers are from a small cohort of 15 patients) and, when present, consist of symmetric T2 FLAIR hyperintensities in the affected areas mentioned above 18,19 . CSF analysis showed normal WBC, RBC, protein, and glucose, with unremarkable infectious and paraneoplastic antibody panels (including evaluation for anti-NMDA antibodies), which diminished likelihood of infectious or autoimmune encephalitis.…”

Section: Neurologymentioning

confidence: 99%

“…Cognitive rehabilitation holds promise, but generally the focus is on occupational therapy 25 . Errorless learning, which utilizes vanishing prompts and cues to promote retention (rather than trial-and-error learning) has been reasonably efficacious in small trials 19 . For example, in one study Korsakoff’s syndrome patients were able to utilize a washing machine after eight training sessions, 24 and in another trial patients increased their daily living and housekeeping chores 26,27 .…”

Section: Neurologymentioning

confidence: 99%

See 2 more Smart Citations

Exploring a Multidisciplinary Approach to Wernicke's Encephalopathy in Pregnancy

Belfer,

Fields,

Gonzalez-Alonso

et al. 2023

Harv Rev Psychiatry

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Section: Neurology Clinical Questionmentioning

confidence: 99%

Section: Neurologymentioning

confidence: 99%

Section: Neurologymentioning

confidence: 99%

See 1 more Smart Citation

Exploring a Multidisciplinary Approach to Wernicke's Encephalopathy in Pregnancy

Belfer,

Fields,

Gonzalez-Alonso

et al. 2023

Harv Rev Psychiatry

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“…Unfortunately, insufficient thiamine treatment is common, such as oral thiamine supplementation or intravenous thiamine supplementation below 500 mg per day, leading to adverse outcome such as chronic immobility and ataxia (dependence on a wheelchair or walking aid), as well as more severe amnesia symptoms [1][2][3]. Recently, both acute and post-acute measures to increase the likelihood of positive outcome have been discussed, showing some positive outcomes of thiamine treatment, intensive physical therapy, structured day schedules, and involvement of a full team of specialists including occupational therapists, physicians, physical therapists, dietarians, and psychologists [19]. Extensive neuropsychological assessment is required at least 6 weeks following treatment of WE, and active efforts to ensure neuropsychological rehabilitation are an integral aspect of treating WE patients [19,20].…”

Section: Introductionmentioning

confidence: 99%

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

Oudman

Wijnia

Bidesie

et al. 2023

JCM

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Wernicke encephalopathy (WE), a neurological emergency commonly associated with alcohol use disorder, results from a severe deficiency of vitamin B1. If left untreated, patients either succumb to the illness or develop chronic Korsakoff’s syndrome (KS). Recently, an increasing number of nonalcoholic WE case studies have been published, highlighting a lack of understanding of malnutrition-related disorders among high-functioning patients. We present the case of a 26 year old female who developed life-threatening WE after COVID-19-complicated obesity surgery. She experienced the full triad of WE symptoms, including eye-movement disorders, delirium, and ataxia, and suffered for over 70 days before receiving her initial WE diagnosis. Late treatment resulted in progression of WE symptoms. Despite the severity, the patient achieved remission of some of the symptoms in the post-acute phase due to prolonged parenteral thiamine injections and intensive specialized rehabilitation designed for young traumatic brain injury (TBI) patients. The rehabilitation resulted in gradual remission of amnesia symptomatology, mainly increasing her autonomy. The late recognition of this case highlights the importance of early diagnosis and prompt, targeted intervention in the management of nonalcoholic WE, as well as underscores the potential for positive outcomes after delayed treatment through intensive cognitive rehabilitation in specialized treatment centers.

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“…In the context of hyperemesis gravidarum, pregnant women have an increased demand for thiamine, which rapidly depletes, leading to WE, and this happens typically between the 14th and 20th weeks of gestation 1 .…”

Section: Introduction and Importancementioning

confidence: 99%

Wernicke encephalopathy revealed by areflexic flaccid tetraparesis associated with gravidarum hyperemesis

Chaib

Mekkaoui

Elmezzeoui

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction: Wernicke’s encephalopathy is an acute neuropsychiatric syndrome resulting from thiamine deficiency, which is associated with significant morbidity and mortality. The diagnosis of Wernicke’s encephalopathy is based on the clinical manifestations and rapid reversal of symptoms with thiamine. Case presentation: The authors present the case of a 25-year-old female patient at the 19th week of gestation (Gravid 1 para 0) with an unremarkable medical history who was admitted to the hospital for an areflexic flaccid tetraparesis with ataxia after persistent vomiting. The brain and spinal MRIs did not reveal any abnormalities, and the evolution was marked by an important improvement after supplementation with thiamine. Conclusion: Gayet Wernicke encephalopathy is a medical emergency. Clinical symptoms are inconstant and varied. MRI is the reference examination to confirm the diagnosis, but in 40% of cases it is strictly normal. Early thiamine administration can prevent morbidity and mortality in pregnant women.

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Wernicke-Korsakoff syndrome diagnostics and rehabilitation in the post-acute phase

Cited by 9 publications

References 46 publications

Exploring a Multidisciplinary Approach to Wernicke's Encephalopathy in Pregnancy

Exploring a Multidisciplinary Approach to Wernicke's Encephalopathy in Pregnancy

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

Wernicke encephalopathy revealed by areflexic flaccid tetraparesis associated with gravidarum hyperemesis

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