Comment on “Wernicke-Korsakoff syndrome despite no alcohol abuse: A summary of systematic reports” – A matter of bariatric patients' management

Despite the prevalence and well-recognized adverse effects of prenatal alcohol exposure and alcohol use disorder in the causation of numerous diseases, their potential roles in the etiology of neurodegenerative diseases remain poorly characterized. This is especially true of the rare neurodegenerative diseases, for which small population sizes make it difficult to conduct broad studies of specific etiological factors. Nonetheless, alcohol has potent and long-lasting effects on neurodegenerative substrates, at both the cellular and systems levels. This review highlights the general effects of alcohol in the brain that contribute to neurodegeneration across diseases, and then focuses on specific diseases in which alcohol exposure is likely to play a major role. These specific diseases include dementias (alcohol-induced, frontotemporal, and Korsakoff syndrome), ataxias (cerebellar and frontal), and Niemann-Pick disease (primarily a Type B variant and Type C). We conclude that there is ample evidence to support a role of alcohol abuse in the etiology of these diseases, but more work is needed to identify the primary mechanisms of alcohol’s effects.

Download Full-text

Thiamine for Wernicke-Korsakoff Syndrome in people at risk from alcohol abuse

10.1002/14651858.cd004033.pub2 ◽

2004 ◽

Cited By ~ 43

Author(s):

Ed Day ◽

Peter Bentham ◽

Rhiannon Callaghan ◽

Turu Kuruvilla ◽

Sanju George

Keyword(s):

At Risk ◽

Alcohol Abuse ◽

Korsakoff Syndrome

Download Full-text

Wernicke-Korsakoff syndrome and other chronic neurological syndromes related to alcohol abuse: prevention in people without home

10.5327/1516-3180.686 ◽

2021 ◽

Author(s):

Derly Judaissy Díaz Rodríguez ◽

Jeffrey Andrés Díaz Rodríguez ◽

Diva Constanza Gil Forero ◽

María Paula Pineda Díaz

Keyword(s):

Alcohol Consumption ◽

Alcohol Abuse ◽

Rio De Janeiro ◽

Complex Interventions ◽

Tertiary Prevention ◽

Fundamental Rights ◽

Homeless Population ◽

Medical Attention ◽

Korsakoff Syndrome ◽

The City

Introduction: The homeless population has a high prevalence of alcoholism and consumption of other drugs, which also means that they are at greater risk of developing all complications resulting from alcohol abuse. (MILER et al, 2021). The medical attention for homeless population is a device of the Unified Health System that claims social, health policies and the guarantee of fundamental rights (BRASIL, 2009). Methods: Evaluation of protocols and referral flows for the treatment of patients with ‘mental disorders and due to alcohol use’, of the medical attention for homeless population in the city of Petrópolis (Rio de Janeiro), between April / 2020 and April 2021, data from e-SUS, and literature review. Results: The city of Petrópolis (Rio de Janeiro) registered 259 people without home, 84.8% are men, all people are adults between 20-74 years old, 98% are born Brazilians, 92% reported alcohol consumption, and alcohol with other drugs 61% (cocaine, crack, marijuana, solvent, tobacco). There was 3 patients with diagnose of Wernicke-Korsakoff syndrome: 2 men and 1 woman (aged 60-65 years) in the period from April 2020 - April 2021 (BRAZIL, 2021 The medical attention for homeless population approach to alcoholism includes the CAGE and AUDIT tests, symptomatic treatment and brief psychological interventions. aimed at weaning, and the Clinical Institute Withdrawal Assessment of Alcohol Scale Revised scale to quantify the degree of abstinence. However, the majority of users do not want total cessation, generally they choose to reduce consumption (secondary prevention), and later recovery and reintegration into society, highlighting that self-help groups and social assistance have a prominent role (tertiary prevention) (MARSCHARLL; GREGANTI, 2002; LONGO, et al., 2013). Conclusion: Despite confounding / aggravating factors such as social determinants in health, and the difficulties of the health network, the medical attention for homeless population is fundamental in the secondary and tertiary prevention of neurological diseases due to chronic alcohol consumption; complex cases require complex interventions, that is, individualization, adaptation and flexibility.

Download Full-text

Wernicke–Korsakoff syndrome: Focus on low-threshold diagnosis and prompt treatment in the primary care setting

The International Journal of Psychiatry in Medicine ◽

10.1177/0091217419832771 ◽

2019 ◽

Vol 54 (3) ◽

pp. 172-180 ◽

Cited By ~ 1

Author(s):

Christopher Yoon ◽

Joanna Gedzior ◽

Dwayne DePry

Keyword(s):

Primary Care ◽

Alcohol Use ◽

General Population ◽

Alcohol Abuse ◽

Primary Care Providers ◽

Care Providers ◽

Prompt Treatment ◽

The Past ◽

Korsakoff Syndrome ◽

Low Threshold

The authors present the case of an inpatient hospitalized at the Veterans Affairs psychiatric unit diagnosed with Wernicke–Korsakoff syndrome to promote awareness of this prevalent yet often underdiagnosed and undertreated condition. Although Veterans present with a unique predisposition for alcohol abuse, it remains problematic in the general population as well. Analysis from 2000 to 2003 reveals alcohol use in the past month in Veterans at 56.6% and 50.8% in comparable non-Veterans. According to the National Survey on Drug Use and Health, it is estimated that of those who are 18 and older, 86.4% have used alcohol, 26.9% have engaged in binge drinking in the past month, 7% engaged in heavy alcohol use in the past month, and 6.2% (15.1 million) carried the diagnosis of alcohol use disorder., The lifetime prevalence of alcohol abuse in the general population is estimated to be between 4.5% and 13.2%. Primary care providers should maintain a high degree of vigilance in evaluating patients for timely diagnosis and prompt treatment of those suspected to have thiamine deficiency. Indeed, Wernicke’s encephalopathy carries a significant level of morbidity and mortality associated with the syndrome, even in cases when it does not present with all of the classic signs. This article aims to raise the primary and ambulatory care provider’s ability to recognize the condition, emphasize a low threshold to treat, and highlight current treatment recommendations.

Download Full-text

Wernicke-Korsakoff syndrome despite no alcohol abuse: A summary of systematic reports

Journal of the Neurological Sciences ◽

10.1016/j.jns.2021.117482 ◽

2021 ◽

pp. 117482

Author(s):

Erik Oudman ◽

Jan W. Wijnia ◽

Misha J. Oey ◽

Mirjam van Dam ◽

Albert Postma

Keyword(s):

Alcohol Abuse ◽

Korsakoff Syndrome

Download Full-text

CONFABULATIONS IN A CHRONIC ALCOHOLIC- A SUBTLE PRESENTATION OF KORSAKOFF SYNDROME

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v7.i7.2019.716 ◽

2019 ◽

Vol 7 (7) ◽

pp. 58-60

Author(s):

Yan Leyfman

Keyword(s):

Case Report ◽

Alcohol Abuse ◽

Retrograde Amnesia ◽

Vitamin B1 ◽

Wernicke Encephalopathy ◽

Chronic Alcoholic ◽

Present Case Report ◽

Personality Changes ◽

Korsakoff Syndrome ◽

Vitamin B1 Deficiency

Wernicke Encephalopathy is an acute neuropsychiatric condition, characterized by confusion, nystagmus, ataxia, and ophthalmoplegia, resulting from thiamine (Vitamin B1) deficiency, typically secondary to alcohol abuse. Failure to properly diagnose, which occurs in 80% of the time, can result in gradual progression to irreversible Korsakoff Syndrome, characterized by irreversible personality changes, and anterograde and retrograde amnesia. The present case report seeks to highlight this patient’s chronology to Korsakoff Syndrome and our attempted interventions.

Download Full-text