ʻO Wernicke-Korsakoff Syndrome

ʻO Wernicke-Korsakoff Syndrome kahi maʻi lolo ma muli o ka lawa ʻole o ka wikamina B1 (thiamine).

ʻO Wernicke encephalopathy a me Korsakoff Syndrome kahi ʻano like ʻole i hana pinepine ʻia. Pili nā mea ʻelua i ka lolo i hōʻino ʻia ma muli o ka nele o ka vitamina B1.

ʻO ka nele o ka wikamina B1 ka mea maʻamau i ka poʻe i loaʻa i ka maʻi ʻona. He mea maʻa mau ia i ka poʻe nona ke kino e ʻānai ʻole i ka meaʻai (malabsorption). Hiki i kēia i kekahi manawa ke hana me ka maʻi maʻi ma hope o ke kaupaʻi ʻana o ke kaupaona (bariatric).

ʻO Korsakoff Syndrome, a i ʻole Korsakoff psychosis, e hoʻomohala e like me Wernicke encephalopathy ke hele aku nā ʻōuli. ʻO ke kumu ʻo Wernicke encephalopathy e hōʻino ai ka lolo ma nā wahi haʻahaʻa o ka lolo i kapa ʻia ʻo thalamus a me hypothalamus. ʻO Korsakoff psychosis nā hopena mai ka pohō mau i nā wahi o ka lolo i pili me ka hoʻomanaʻo.

ʻO nā ʻōuli o Wernicke encephalopathy me:

• Huikau a me ka nalo ʻana o ka hana noʻonoʻo e hiki ke holomua i ka koma a me ka make
• Ka nalowale ʻana o ka hoʻohuihui puʻupuʻu (ataxia) i hiki ke hoʻonāukiuki i ka wāwae
• Hoʻololi ka hihiʻo e like me nā neʻe ʻana o ka maka maʻamau (neʻe i hope a i hope i kapa ʻia ʻo nystagmus), ʻike pālua, kuʻu maka.
• ʻO ka haʻalele ʻana i ka ʻalekohola

Nā ʻōuli o Korsakoff Syndrome:

• ʻAʻole hiki ke hana i nā mea hoʻomanaʻo hou
• ʻO ka nalowale o ka hoʻomanaʻo, hiki ke koʻikoʻi
• Ke haku nei i nā moʻolelo (confabulation)
• Ke ʻike a lohe ʻana paha i nā mea ʻaʻole ma laila (hallucination)

Hōʻike paha ka loiloi ʻana i ka ʻōnaehana hopohopo / muscular i ka hōʻino ʻana i nā ʻōnaehana nerve he nui:

• Holo maka maka ʻole
• Hoʻoemi i ka refre
• Puʻupuʻu wikiwiki (ka helu o ka puʻuwai)
• Kaomi haʻahaʻa
• Mahana haʻahaʻa kino
• ʻO ka nāwaliwali a me ke atrophy
• Nā pilikia me ka hele (hele) a me ka hoʻohui ʻana

ʻIke kino maikaʻi ʻole ʻia ke kanaka. Hoʻohana ʻia nā hōʻike aʻe e nānā ai i ka pae o ka meaʻai a ke kanaka.

• Serum albumin (e pili ana i ka meaʻai āpau o ke kanaka)
• Nā pae vitamin B1 Serum
• ʻO ka hana Transketolase i nā hunaola ʻulaʻula (hoʻemi ʻia i ka poʻe me ka hemahema thiamine)

Hiki ke kiʻekiʻe nā enzymes o ke akepaʻa i ka poʻe me ka mōʻaukala o ka hōʻino wā lōʻihi.

ʻO nā kumu ʻē aʻe e hiki ke kumu i ka hemahema o ka wikamina B1:

• HIV / AIDS
• Nā maʻi maʻi i pālahalaha aʻe i ke kino
• Kaʻi nui a me ka luaʻi i ka wā hāpai (hyperemesis gravidarum)
• Hoka ʻole (ke mālama ʻia me ka diuretic therapy lōʻihi)
• Nā wā lōʻihi o ka intravenous (IV) therapy me ka loaʻa ʻole o nā thiamine supplement
• Dialysis wā lōʻihi
• Nā pae hormonone thyroid kiʻekiʻe loa (thyrotoxicosis)

Hōʻike kahi MRI lolo i nā loli i ka kiko o ka lolo. Akā inā ua kānalua ʻia ʻo Wernicke-Korsakoff Syndrome, pono e hoʻomaka koke ka mālama ʻana. ʻO ka maʻamau ʻaʻole pono kahi hōʻike MRI lolo.

ʻO nā pahuhopu o ka mālama ʻana e kaohi i nā ʻōuli a pale i ka maʻi mai ʻinoʻino. Pono paha kekahi poʻe e noho i ka haukapila i ke kakahiaka i ke ʻano e kōkua ai i ka mālama ʻana i nā ʻōuli.

Pono paha ka nānā a me ka mālama kūikawā inā ʻo ke kanaka:

• I kahi koma
• Lethargic
• Manaʻo ʻole

Hāʻawi pinepine ʻia ka Vitamin B1 e ka injection i loko o kahi aa a i ʻole kahi mākala i ka hiki wawe. Hiki i kēia ke hoʻomaikaʻi i nā ʻōuli o:

• Huikau a delirium paha
• Nā paʻakikī me ka ʻike a me ka neʻe ʻana o ka maka
• Ka nele o ka hoʻohui ʻana i nā mākala

ʻAʻole hoʻomaikaʻi pinepine ka Vitamin B1 i ka nalo ʻana o ka hoʻomanaʻo a me ka ʻike e kū nei me Korsakoff psychosis.

Hiki i ke kū ʻana i ka waiʻona ke pale aku i ka nui o ka nalowale o ka hana o ka lolo a me ka hōʻino ʻana i nā ʻalolo. Hiki i ke kaulike kaulike, hānai pono ke kōkua, akā ʻaʻole ia he mea pani no ka hoʻōki ʻana i ka hana ʻona.

Me ka ʻole o ka lapaʻau ʻana, ʻoi aku ka hewa o Wernicke-Korsakoff maʻi, a hiki ke hoʻoweliweli i ke ola. Me ka lāʻau, hiki ke kaohi i nā ʻōuli (e like me ka neʻe ʻana ʻole o ka neʻe ʻana a me nā pilikia ʻike. Hiki ke hoʻolohi a hoʻopau ʻia kēia maʻi.

Nā pilikia e hopena paha me:

• ʻO ka haʻalele ʻana i ka ʻalekohola
• Ka paʻakikī me ka pilikino a pilikino paha
• Ka ʻeha ma muli o ka hāʻule
• ʻO ka neuropathy ʻona paʻa
• Lilo paʻa o ka noʻonoʻo noʻonoʻo
• Ka nalowale paʻa ʻana o ka hoʻomanaʻo
• Hoʻopōkole ʻia ke kīnā o ke ola

Kāhea i kāu mea mālama ola a i ʻole hele i ka lumi pilikia inā loaʻa iā ʻoe nā ʻōuli o Wernicke-Korsakoff Syndrome, a i ʻole inā ua ʻike ʻia ʻoe me ka maʻi a hōʻeha a hoʻi paha kāu mau ʻōuli.

ʻO ka inu ʻole ʻana i ka wai ʻona a inu paha i ka hoʻohaʻahaʻa a loaʻa ka lawa ʻana o ka meaʻai e hōʻemi i ka makaʻu o Wernicke-Korsakoff Syndrome. Inā ʻaʻole e haʻalele kahi mea inu mea kaumaha, hiki i ka thiamine supplement a me kahi papaʻai maikaʻi ke hoʻēmi i ka manawa o ka loaʻa ʻana o kēia ʻano, akā ʻaʻole e hoʻopau ʻia ka pilikia.

Korsakoff psychosis; Encephalopathy ʻalekohola; Encephalopathy - ʻalekohola; Maʻi ʻo Wernicke; Hoʻohana waiʻona - Wernicke; ʻAlekohola - Wernicke; Ka hemahema o Thiamine - Wernicke

• ʻŌnaehana ʻōnaehana waena a me ka ʻōnaehana ʻōnaehana peripheral
• Lolo
• Nā hanana lolo

ʻO Koppel BS. Nā maʻi neurologic pili i kaʻai a me ka waiʻona. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 388.

No laila YT. Nā maʻi kūpono ʻole o ka ʻōnaehana. I: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. ʻO Bradley's Neurology i ka hana lapaʻau. ʻEpekema 7 Piladelapia, PA: Elsevier; 2016: chap 85.