Korsakoff's Psychosis - Revision history

Neil.m.young: Redirected page to Wernicke-Korsakoff syndrome

2016-04-09T19:27:14Z

Redirected page to Wernicke-Korsakoff syndrome

← Older revision		Revision as of 19:27, 9 April 2016
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	#REDIRECT[[Wernicke-Korsakoff ~~Syndrome~~]]		#REDIRECT[[Wernicke-Korsakoff syndrome]]

Rossdonaldson1: Redirected page to Wernicke-Korsakoff Syndrome

2013-09-23T06:35:34Z

Redirected page to Wernicke-Korsakoff Syndrome

← Older revision		Revision as of 06:35, 23 September 2013
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	~~==Background==~~		#REDIRECT[[Wernicke-Korsakoff Syndrome]]
	*Wernicke’s Encephalopathy (WE): ACUTE neuro/cardiovascular sx caused by thiamine deficiency
	*Korsakoff’s Psychosis (KP): CHRONIC neuro sx caused by thiamine deficiency
	*Wernicke-Korsakoff Syndrome (WKS): presence of WE + KP simultaneously

	~~==Epidemiology==~~
	*Only 20% identified before death, failure of dx leads to 20% mortality and 75% permanent damage

	~~==Causes==~~
	*Anything that causes thiamine (vitamin B1) deficiency: poor dietary intake, malabsorption, increased metabolic requirement
	**Chronic alcoholism, dieting/fasting/starvation, anorexia, vomiting/diarrhea, unbalanced TPN, GI surgery, malignancy, dialysis, AIDS, IBD, pancreatitis, liver disease, thyrotoxicosis

	~~==Pathophysiology==~~
	*Brain lesions/atrophy occurs: mamillary bodies (nearly all cases), thalamus, periaqueductal gray matter, 3rd/4th ventricle, cerebellum, frontal lobe

	~~==Diagnosis==~~
	~~WE/KP/WKS = clinical diagnoses~~


	~~Wernicke’s Encephalopathy~~
	*Classic triad: encephalopathy, oculomotor dysfunction, gait ataxia
	*werNICke mnemonic:
	**N: Nystagmus/ophthalmoplegia
	**I: Incoordination/ataxia
	**C: Confusion/memory impairment
	*Other sx: hypotension, tachycardia, EKG abnormalities, DOE, CHF sx, hypothermia, coma, dry/wet Beriberi


	~~Korsakoff’s Psychosis~~
	*Sx: anterograde/retrograde amnesia, confabulation, confusion, apathy


	~~Wernicke-Korsakoff Syndrome~~
	*Sx: combination of WE and KP

	~~==Treatment==~~
	~~If suspect WE/KP/WKS: thiamine 500 mg IV over 30 min TID x 2 days, then 500 mg IV/IM q day for 5 days, then 100 mg PO q day until pt no longer at risk~~


	~~If suspect at risk for thiamine deficiency but no sx: thiamine 100 mg PO q day~~


	*If you suspect WE/KP/WKS then treat it! Diagnosis is clinical and difficult to confirm, treatment is simple/inexpensive/effective, there is little risk to treatment, and the risk of morbidity/mortality from not treating is high

	*Give magnesium; hypomagnesemic state may be resistant to thiamine administration

	*Give multivitamin; pt at risk for other vitamin deficiencies

	*For chronic alcoholics always consider banana bag: thiamine 100 mg + magnesium 2-4 g + folate 1 mg + multivitamin; all in 1L NS or D5W

	*Remember to give thiamine BEFORE glucose in pts requiring glucose who are at risk for thiamine deficiency; glucose without thiamine can precipitate/worsen WE by driving thiamine intracellularly

	~~==See Also==~~
	*[[Wernicke's Encephalopathy]]
	*[[Wernicke-Korsakoff Syndrome]]
	*[[Beriberi]]
	*[[Thiamine deficiency]]

Mhankerson at 15:46, 20 September 2013

2013-09-20T15:46:44Z

← Older revision		Revision as of 15:46, 20 September 2013
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	*For chronic alcoholics always consider banana bag: thiamine 100 mg + magnesium 2-4 g + folate 1 mg + multivitamin; all in 1L NS or D5W		*For chronic alcoholics always consider banana bag: thiamine 100 mg + magnesium 2-4 g + folate 1 mg + multivitamin; all in 1L NS or D5W

			*Remember to give thiamine BEFORE glucose in pts requiring glucose who are at risk for thiamine deficiency; glucose without thiamine can precipitate/worsen WE by driving thiamine intracellularly

	==See Also==		==See Also==

Mhankerson: minor edit

2013-09-19T15:26:36Z

minor edit

← Older revision		Revision as of 15:26, 19 September 2013
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	*[[Wernicke's Encephalopathy]]		*[[Wernicke's Encephalopathy]]
	*[[Wernicke-Korsakoff Syndrome]]		*[[Wernicke-Korsakoff Syndrome]]
			*[[Beriberi]]
			*[[Thiamine deficiency]]

Mhankerson: new note

2013-09-19T15:22:25Z

new note

New page

==Background==
*Wernicke’s Encephalopathy (WE): ACUTE neuro/cardiovascular sx caused by thiamine deficiency
*Korsakoff’s Psychosis (KP): CHRONIC neuro sx caused by thiamine deficiency
*Wernicke-Korsakoff Syndrome (WKS): presence of WE + KP simultaneously

==Epidemiology==
*Only 20% identified before death, failure of dx leads to 20% mortality and 75% permanent damage

==Causes==
*Anything that causes thiamine (vitamin B1) deficiency: poor dietary intake, malabsorption, increased metabolic requirement
**Chronic alcoholism, dieting/fasting/starvation, anorexia, vomiting/diarrhea, unbalanced TPN, GI surgery, malignancy, dialysis, AIDS, IBD, pancreatitis, liver disease, thyrotoxicosis

==Pathophysiology==
*Brain lesions/atrophy occurs: mamillary bodies (nearly all cases), thalamus, periaqueductal gray matter, 3rd/4th ventricle, cerebellum, frontal lobe

==Diagnosis==
WE/KP/WKS = clinical diagnoses

Wernicke’s Encephalopathy
*Classic triad: encephalopathy, oculomotor dysfunction, gait ataxia
*werNICke mnemonic:
**N: Nystagmus/ophthalmoplegia
**I: Incoordination/ataxia
**C: Confusion/memory impairment
*Other sx: hypotension, tachycardia, EKG abnormalities, DOE, CHF sx, hypothermia, coma, dry/wet Beriberi

Korsakoff’s Psychosis
*Sx: anterograde/retrograde amnesia, confabulation, confusion, apathy

Wernicke-Korsakoff Syndrome
*Sx: combination of WE and KP

==Treatment==
If suspect WE/KP/WKS: thiamine 500 mg IV over 30 min TID x 2 days, then 500 mg IV/IM q day for 5 days, then 100 mg PO q day until pt no longer at risk

If suspect at risk for thiamine deficiency but no sx: thiamine 100 mg PO q day

*If you suspect WE/KP/WKS then treat it! Diagnosis is clinical and difficult to confirm, treatment is simple/inexpensive/effective, there is little risk to treatment, and the risk of morbidity/mortality from not treating is high

*Give magnesium; hypomagnesemic state may be resistant to thiamine administration

*Give multivitamin; pt at risk for other vitamin deficiencies

*For chronic alcoholics always consider banana bag: thiamine 100 mg + magnesium 2-4 g + folate 1 mg + multivitamin; all in 1L NS or D5W

==See Also==
*[[Wernicke's Encephalopathy]]
*[[Wernicke-Korsakoff Syndrome]]