Isifo seWernicke-Korsakoff

I-Wernicke-Korsakoff syndrome iyinkinga yobuchopho ngenxa yokushoda kukavithamini B1 (thiamine).

I-Wernicke encephalopathy ne-Korsakoff syndrome yizimo ezahlukahlukene ezivame ukuvela ndawonye. Kokubili kungenxa yokulimala kobuchopho okubangelwa ukungabi novithamini B1.

Ukuntuleka kukavithamini B1 kuvamile kubantu abanenkinga yokusebenzisa utshwala. Kuyinsakavukela kubantu abanemizimba engakumunci ukudla ngokufanele (malabsorption). Lokhu kwesinye isikhathi kungenzeka ngokugula okungalapheki noma ngemuva kokuhlinzwa kwesisindo (i-bariatric).

I-Korsakoff syndrome, noma i-Korsakoff psychosis, ijwayele ukukhula njenge-Wernicke encephalopathy njengoba izimpawu ziphela. I-Wernicke encephalopathy ibangela ukulimala kobuchopho ezingxenyeni ezingezansi zobuchopho ezibizwa nge-thalamus ne-hypothalamus. I-Korsakoff psychosis ibangelwa ukulimala unomphela ezindaweni zobuchopho ezibandakanyeka kwimemori.

Izimpawu ze-Wernicke encephalopathy zifaka:

• Ukudideka nokulahleka kwemisebenzi yengqondo engathuthukela ekuqulekeni nasekufeni
• Ukulahleka kokuhlanganiswa kwemisipha (ataxia) okungadala ukuthuthumela kwemilenze
• Izinguquko zombono ezinjengokunyakaza okungavamile kwamehlo (ukunyakaza emuva naphambili okubizwa ngokuthi i-nystagmus), ukubona kabili, ijwabu leso
• Ukuhoxiswa kotshwala

Izimpawu ze-Korsakoff syndrome:

• Ukungakwazi ukwakha izinkumbulo ezintsha
• Ukulahleka kwenkumbulo, kungaba nzima
• Ukwenza izindaba (ukuxubana)
• Ukubona noma ukuzwa izinto ezingekho ngempela (ukusangana)

Ukuhlolwa kwesistimu yezinzwa / yemisipha kungakhombisa ukulimala kuzinhlelo eziningi zemizwa:

• Ukuhamba kwamehlo okungavamile
• Ukucabanga okunciphile noma okungajwayelekile
• Ukushaya ngamandla (ukushaya kwenhliziyo)
• Umfutho wegazi ophansi
• Izinga lokushisa lomzimba eliphansi
• Ubuthakathaka bemisipha kanye ne-atrophy (ukulahleka kwesisindo somzimba)
• Izinkinga ngokuhamba (ukuhamba) nokuxhumanisa

Umuntu angabonakala engondlekile kahle. Ukuhlolwa okulandelayo kusetshenziselwa ukuhlola izinga lomuntu lokudla:

• I-serum albumin (iphathelene nokudla komuntu okuvamile)
• Amazinga weSerum vitamin B1
• Umsebenzi weTransketolase kumaseli abomvu egazi (ancishisiwe kubantu abanesifo se-thiamine)

Ama-enzyme wesibindi angaba phezulu kubantu abanomlando wokusebenzisa kabi utshwala isikhathi eside.

Ezinye izimo ezingadala ukushoda kwe-vitamin B1 zifaka:

• I-HIV / AIDS
• Umdlavuza osabalele umzimba wonke
• Isicanucanu esikhulu nokuhlanza ngesikhathi sokukhulelwa (hyperemesis gravidarum)
• Ukwehluleka kwenhliziyo (lapho uphathwa ngokwelashwa kwesikhathi eside kokukhishwa isisu)
• Izinkathi ezinde zokwelashwa ngemithambo (IV) ngaphandle kokuthola izithasiselo ze-thiamine
• I-dialysis yesikhathi eside
• Amazinga aphezulu kakhulu e-hormone yegilo (thyrotoxicosis)

I-MRI yobuchopho ingakhombisa ushintsho kwezicubu zobuchopho. Kepha uma kusolwa i-Wernicke-Korsakoff syndrome, ukwelashwa kufanele kuqale ngokushesha. Imvamisa ukuhlolwa kobuchopho be-MRI akudingeki.

Izinhloso zokwelashwa ukulawula izimpawu nokuvikela ukuthi lesi sifo singabi sibi kakhulu. Abanye abantu bangadinga ukuhlala esibhedlela ekuqaleni kwesimo ukusiza ukulawula izimpawu.

Ukuqapha nokunakekelwa okukhethekile kungadingeka uma umuntu:

• Ku-coma
• I-Lethargic
• Uqulekile

UVitamin B1 uvame ukunikezwa ngomjovo emthanjeni noma emsipheni ngokushesha okukhulu. Lokhu kungathuthukisa izimpawu ze:

• Ukudideka noma i-delirium
• Ubunzima ngombono nokunyakaza kwamehlo
• Ukuntuleka kokuhlangana kwemisipha

I-Vitamin B1 imvamisa ayithuthukisi ukulahleka kwememori nokuqonda okwenzeka nge-Korsakoff psychosis.

Ukuyeka ukusetshenziswa kotshwala kungavimbela ukulahleka okuningi kokusebenza kobuchopho kanye nokulimala kwezinzwa. Ukudla okunomsoco, okunomsoco kungasiza, kepha akuyona indawo yokumisa ukusetshenziswa kotshwala.

Ngaphandle kokwelashwa, i-Wernicke-Korsakoff syndrome iya ngokuya iba yimbi, futhi ingasongela impilo. Ngokwelashwa, kungenzeka ukulawula izimpawu (njengokuhamba okungalawuleki nobunzima bokubona). Lesi sifo singahle sehliswe noma simiswe.

Izinkinga ezingaba nomphumela zifaka:

• Ukuhoxiswa kotshwala
• Ubunzima ngokuxhumana komuntu siqu noma komphakathi
• Ukulimala okubangelwa ukuwa
• I-neuropathy engapheli yotshwala
• Ukulahlekelwa unomphela kwamakhono okucabanga
• Inkumbulo engapheli
• Isikhathi esifushane sokuphila

Shayela umhlinzeki wakho wezokunakekelwa kwempilo noma uye egumbini lezimo eziphuthumayo uma unezimpawu ze-Wernicke-Korsakoff syndrome, noma uma utholakale unaleso sifo futhi izimpawu zakho ziba zimbi kakhulu noma zibuya.

Ukungaphuzi utshwala noma ukuphuza ngokulinganisela nokuthola ukondleka okwanele kunciphisa ubungozi bokuthola isifo seWernicke-Korsakoff. Uma umuntu ophuza ngokweqile engayeki, izithasiselo ze-thiamine kanye nokudla ngendlela efanele kunganciphisa amathuba okuthola lesi simo, kepha ubungozi abuqedwa.

I-Korsakoff psychosis; I-encephalopathy yotshwala; I-Encephalopathy - utshwala; Isifo sikaWernicke; Ukusetshenziswa kotshwala - iWernicke; Ukuphuza ngokweqile - iWernicke; Ukushoda kweThiyamine - iWernicke

• Isistimu yezinzwa emaphakathi nesistimu yezinzwa ezungezayo
• Ubuchopho
• Izakhiwo zobuchopho

I-Koppel BS. Izinkinga ze-neurologic ezihlobene nokudla okunempilo kanye notshwala. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 388.

Ngakho-ke i-YT. Ukuntuleka kwezifo zesimiso sezinzwa. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 85.