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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.
Highlights
Wernicke’s encephalopathy (WE) is an acute neuropsychiatric syndrome resulting from vitamin B1 deficiency [1]
When patients with WE are promptly treated with parenteral thiamine replacement therapy, this is a life-saving measure that may prevent the development of chronic brain damage [6]
OBSERVATIONS AND NEUROPSYCHOLOGICAL ASSESSMENT ON T1 Qualitative observations on T1 showed a consistent pattern of striking impairments
Summary
Wernicke’s encephalopathy (WE) is an acute neuropsychiatric syndrome resulting from vitamin B1 (thiamine) deficiency [1]. When patients with WE are promptly treated with parenteral thiamine replacement therapy, this is a life-saving measure that may prevent the development of chronic brain damage [6]. In the patients who survive with this lack of treatment, varying degrees of brain damage develop, the exact course of illness is not well-understood [7]. KS follows WE when acute confusion improves within one to a couple of weeks. Primary characteristics of this improvement include the ability to concentrate for a longer time, less incoherence in behavior, and clear consciousness over the course of the day despite severe amnesia [8,9,10]
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