The effectiveness of using thiamine in the Wernicke-Korsakoff syndrome

Introduction: The Wernicke-Korsakoff syndrome is a condition caused by thiamine (vitamin B1) deficiency in the brain, being a debilitating and potentially fatal factor. It is characterized by a classic triad: delirium, ophthalmoparesis and ataxia. Objectives: Analyze the possible effectiveness of using thiamine in the prognostic change of patients with the syndrome, as well as the ideal dose and identification of possible secondary outcomes of the use of thiamine. Methods: A systematic review made in March 2021, included studies published between 2011-2021. The descriptors selected according to the MeSH platform, were inserted in the SCIELO, Lilacs and PubMed databases, resulting in a total of 323 studies, of which only 8 were selected. Results: Among the 8 evaluated articles, 5 reinforce the effectiveness of thiamine therapy, with prognostic changes in those patients, and only 4 of these studies describe their clinical evolution, showing mostly a gradual regression of the ocular manifestations and ataxia, while neurological symptoms tend to develop later. Thus 62,5% of the articles show improvement of patients with these therapeutics. Other studies do not refer to the prognosis after the institution of the treatment. About the dose, it was observed that the therapeutic effectiveness was related to higher doses of thiamine. Conclusion: Most of the analyzed studies were favorable to the hypothesis of the early use of thiamine in regression of the symptoms. Regarding the most effective dose, the topic still needs studies with high scientific evidence, as it hasn’t yet been thoroughly discussed in the literature.

Wernicke Encephalopathy as a Complication of Hyperemesis Gravidarum: Case Report

Wernicke encephalopathy (WE) is an acute neurological disorder resulting from vitamin B1 deficiency, which is common in chronic alcoholism. We report a rare case of WE due to hyperemesis gravidarum in a 25-year-old pregnant patient at 13 weeks and 5 days of gestation. Initially, the disease manifested as weakness, mental confusion, anterograde amnesia, and visual and auditory hallucinations. The diagnosis was established after the detection of suggestive findings of WE in the thalamus by magnetic resonance imaging (MRI) and a rapid improvement in the patient's clinical status subsequent to treatment with thiamine. Hyperemesis is a rare cause of WE, which makes the reported case important in the literature and reinforces the need for attention in clinical practice to rare but important complications of this common condition (hyperemesis gravidarum).

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

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.