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We report a case of a 56-year old woman with a history of depressive disorder between 2012 and 2017 achieving full remission after treatment with antidepressants and anxiolytics. In the year 2021 was presented to the emergency department manifesting alteration of behavioral patterns, ataxia, mental confusion and horizontal nystagmus. A chronic alcohol abuse was also discovered while interviewing. She also exhibited low mood, anterograde amnesia and confabulations that improved rapidly after following treatment with thiamine.
Objectives
Reviewing clinical manifestations and treatment of Wernicke encephalopathy and the development of Korsakoff syndrome.
Methods
We systematically reviewed articles using PubMed.
Results
Wernicke encephalopathy is a well-known complication of thiamine deficiency, mostly associated with alcohol use disorder. Classically, the syndrome comprises changes in mental status, gait ataxia and ophthalmoplegia. However, the full triad has been described in only 10-17 % of cases, which in our the case is report. After the diagnosis was established and was treated with thiamine, a rapid improvement in the patient´s clinical status was observed. Cognitive impairment was later identified, taking into account the possibility of a Korsakoff syndrome characterized by irreversible brain damage and subsequent loss of anterograde memory. In our patient, this specific diagnosis was dismissed due to the clinical improvement after thiamine treatment.
Conclusions
It is relevant to emphasize the importance of a precise diagnosis and treatment of patients with Wernicke Encephalopathy to avoid the development of a Korsakoff syndrome.
This article describes an exploratory study of MMPI-2 administration to 20 patients with Korsakoff's disease, all admitted to the Korsakoff unit of a major psychiatric hospital in the Netherlands.
Methods:
We compared their MMPI-2 basic profiles with those of an inpatient alcohol-dependent non-Korsakoff group. Attention was also given to content scales and some selected supplementary scales. Furthermore, we explored the differences between MMPI-2 profiles of Korsakoff patients with and without insight into oneself and one's disease.
Results:
Compared with both the Dutch norms and the scale means of the non-Korsakoff alcoholics, Korsakoff patients showed an extraordinary flat profile. Illness insight appeared to be related to the levels of the various scales.
Discussion:
The results show the potential usefulness of the MMPI-2 in the differential diagnosis of chronic alcoholism and Korsakoff's disease.
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