RESUMO
Wernicke's encephalopathy may be fatal if untreated. Because Wernicke's encephalopathy is suspected to be underdiagnosed in children, the authors wished to assess the frequency of overlooked diagnosis and to establish pertinent findings that could lead to early identification of pediatric Wernicke's encephalopathy. The authors performed multiple literature searches seeking pediatric patients with Wernicke's encephalopathy (age = 20 years or younger). A total of 30 patients was found, and the authors added a new patient. Each case report had its clinical, radiologic, and laboratory data, diagnostic method, and outcome analyzed. Of 31 patients, 16 were female and 15 male; the median age +/- S.D. was 11 +/- 6.5 years. The most frequent underlying disorder was malignancy in 11. Thirteen patients died undiagnosed, 16 recovered with thiamine therapy (eight with sequelae), and two died of infection soon after thiamine replacement was initiated. Only six presented with the Wernicke's encephalopathy clinical triad (mental status changes, ocular signs, and ataxia) at neurologic onset; nine eventually demonstrated this triad. The high rate of patients diagnosed only at postmortem examination (41.9%) confirms that Wernicke's encephalopathy is underdiagnosed in children. Thiamine therapy is warranted if any component of the Wernicke's encephalopathy triad is present in an appropriate clinical setting.
Assuntos
Deficiência de Tiamina/complicações , Tiamina/uso terapêutico , Encefalopatia de Wernicke/diagnóstico , Encefalopatia de Wernicke/terapia , Adolescente , Adulto , Criança , Pré-Escolar , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Síndromes de Malabsorção/complicações , Masculino , Necessidades Nutricionais , Papiledema/etiologia , Nutrição Parenteral/efeitos adversos , Hemorragia Retiniana/etiologia , Deficiência de Tiamina/terapia , Resultado do Tratamento , Encefalopatia de Wernicke/etiologiaRESUMO
Alcohol abuse is one of the most serious problems in public health and the Wernicke-Korsakoff syndrome is one of the gravest consequences of alcoholism. The pathology is often undiagnosed in its less evident presentations, therefore an accurate diagnostic approach is a critical step in treatment planning. Treatment is based on restoration of thiamine, although this is insufficient to prevent the psychological decline of a great number of patients. The cognitive impact of the pathology is derived from the interaction of alcoholic neurotoxicity, thiamine deficiency and personal susceptibility. In this article, the literature concerning Wernicke-Korsakoff syndrome is reviewed.
Assuntos
Transtorno Amnésico Alcoólico/fisiopatologia , Doenças Metabólicas/fisiopatologia , Encefalopatia de Wernicke/fisiopatologia , Transtorno Amnésico Alcoólico/etiologia , Transtorno Amnésico Alcoólico/história , Transtorno Amnésico Alcoólico/patologia , Transtorno Amnésico Alcoólico/terapia , Alcoolismo/complicações , História do Século XIX , Humanos , Doenças Metabólicas/etiologia , Doenças Metabólicas/história , Doenças Metabólicas/patologia , Doenças Metabólicas/terapia , Prognóstico , Síndrome , Tiamina/uso terapêutico , Deficiência de Tiamina/complicações , Encefalopatia de Wernicke/etiologia , Encefalopatia de Wernicke/história , Encefalopatia de Wernicke/patologia , Encefalopatia de Wernicke/terapiaRESUMO
El presente trabajo tiene por objeto la presentación de un paciente portador de una encefalopatía de Wernicke internado en la sala de Salud Mental del Hospital Maciel. Se destaca la importancia de dicha internación en un servicio psiquiátrico que funciona en un hospital general, ya que esto posibilita un abordaje multidisciplinario más eficiente, y permite efectuar un diagnóstico precoz a la vez que evita consecuencias invalidantes severas a las cuales puede llevar esta afección(AU)
Assuntos
INFORME DE CASO , Humanos , Masculino , Pessoa de Meia-Idade , Encefalopatia de Wernicke/diagnóstico , Encefalopatia de Wernicke/terapiaRESUMO
El presente trabajo tiene por objeto la presentación de un paciente portador de una encefalopatía de Wernicke internado en la sala de Salud Mental del Hospital Maciel. Se destaca la importancia de dicha internación en un servicio psiquiátrico que funciona en un hospital general, ya que esto posibilita un abordaje multidisciplinario más eficiente, y permite efectuar un diagnóstico precoz a la vez que evita consecuencias invalidantes severas a las cuales puede llevar esta afección