Wernicke-Korsakoff syndrome: Year of the Zebra

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Wernicke-Korsakoff syndrome is a rare neurological condition that causes degeneration of brain cells, or neuronal atrophy. It is caused by thiamine, or vitamin B1, deficiency. Thiamine is a vitamin absorbed in the intestines and used for energy metabolism to support growth, development, and cellular functioning, especially in the brain and nervous system

Thiamine deficiencies are commonly seen with conditions that lead to malnutrition, such as chronic alcohol use. The condition includes two stages: Wernicke encephalopathy, which is the acute and reversible stage; and Korsakoff syndrome, which is when the condition progresses to a chronic and irreversible stage.

Now, Wernicke-Korsakoff syndrome commonly presents with the triad of altered mental status, including confusion and memory deficits; nystagmus, or involuntary, rapid, and repetitive movement of the eyes; and ataxia, or impaired coordination of voluntary movements, balance, and speech

Other symptoms that may develop include agitation, hallucinations, and confabulation, which is when affected individuals create stories they believe to be true, to fill gaps in their memory. 

Sources

  1. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  2. "Vitamin Deficiency and Systemic Failure: The Case For Greater Focus On Wernicke-Korsakoff Syndrome." Ir Med J. (2018 Dec 6)
  3. "Wernicke-Korsakoff Syndrome." Ir Med J. (March 15, 2019)
  4. "Wernicke-Korsakoff syndrome: Focus on low-threshold diagnosis and prompt treatment in the primary care setting." Int J Psychiatry Med. (2019)
  5. "Wernicke-Korsakoff Syndrome" National Institute of Neurological Disorders and Stroke