Τίτλος:
Non-alcoholic Korsakoff syndrome in psychiatric patients with a history of undiagnosed Wernicke's encephalopathy
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Wernicke's encephalopathy is often undiagnosed, particularly in non-alcoholics. There are very few reports of non-alcoholic patients diagnosed with Korsakoff syndrome in the absence of a prior diagnosis of Wernicke's encephalopathy and no studies of diffusion tensor imaging in non-alcoholic Korsakoff syndrome. We report on three non-alcoholic psychiatric patients (all women) with long-term non-progressive memory impairment that developed after malnutrition accompanied by at least one of the three Wernicke's encephalopathy manifestations: ocular abnormalities, ataxia or unsteadiness, and an altered mental state or mild memory impairment. In neuropsychological examination, all patients had memory impairment, including intrusions. One patient had mild cerebellar vermis atrophy in MRI taken after the second episode of Wernicke's encephalopathy. The same patient had mild hypometabolism in the lateral cortex of the temporal lobes. Another patient had mild symmetrical atrophy and hypometabolism of the superior frontal lobes. Two patients were examined with diffusion tensor imaging. Reduced fractional anisotropy values were found in the corona radiata in two patients, and the uncinate fasciculus and the inferior longitudinal fasciculus in one patient. Our results suggest that non-alcoholic Korsakoff syndrome is underdiagnosed. Psychiatric patients with long-term memory impairment may have Korsakoff syndrome and, therefore, they should be evaluated for a history of previously undiagnosed Wernicke's encephalopathy. © 2016 Elsevier B.V.
Συγγραφείς:
Nikolakaros, G.
Ilonen, T.
Kurki, T.
Paju, J.
Papageorgiou, S.G.
Vataja, R.
Περιοδικό:
Journal of the Neurological Sciences
Λέξεις-κλειδιά:
amfebutamone; antibiotic agent; citalopram; clonazepam; cortisone; duloxetine; escitalopram; gabapentin; lamotrigine; nortriptyline; venlafaxine, adult; anisocoria; antibiotic therapy; Article; ataxia; case report; cerebellum atrophy; cerebellum vermis; clinical feature; corona radiata (brain); corticosteroid therapy; diagnostic error; diffusion tensor imaging; drug treatment failure; drug withdrawal; episodic memory; eye disease; fatigue; female; fractional anisotropy; gastroenteritis; Hopkins verbal learning test; human; immunoglobulin deficiency; inferior longitudinal fasciculus; Korsakoff psychosis; major depression; medical leave; memory disorder; mental health; mental patient; middle aged; neurasthenia; neuroimaging; neuropsychological test; neuropsychology; non alcoholic korsakoff syndrome; peripheral neuropathy; pneumonia; priority journal; psychopharmacotherapy; psychosis; pyelonephritis; systemic lupus erythematosus; temporal cortex; uncinate fasciculus; unspecified side effect; unsteadiness; urticaria; visual memory; weight reduction; working memory; brain; comorbidity; complication; diagnostic imaging; differential diagnosis; Korsakoff Syndrome; positron emission tomography; psychology; Wernicke encephalopathy, Adult; Brain; Comorbidity; Diagnosis, Differential; Diffusion Tensor Imaging; Female; Humans; Korsakoff Syndrome; Middle Aged; Neuropsychological Tests; Positron-Emission Tomography; Wernicke Encephalopathy
DOI:
10.1016/j.jns.2016.09.025
