Wernicke-Korsakow-Enzephalopathie

Wernicke-Enzephalopathie und Korsakow-Syndrom beschreiben zwei Ausprägungen der Hirnerkrankung infolge eines Vitamin-B1-Mangels (Thiamin). Fast 150 Jahre nach den ersten Fallbeschreibungen ist die Diagnose wegen der vielfältigen Symptome weiterhin schwierig und wird nicht selten verzögert gestellt. Dieser Beitrag zeigt, welche klinischen Zeichen und Befunde helfen, um die gut behandelbare Erkrankung rasch und zuverlässig zu erkennen.

• Literatur

• 1 Wernicke C. Die akute haemorrhagische polioencephalitis superior. Kassel: Theodor Fischer; 1881
• 2 Korsakow S. Über eine besondere Form psychischer Störung, kombiniert mit multipler Neuritis. Arch Psychiat Nervenkr 1890; 21: 669-704
• 3 Campbell ACP, Russel WR. Wernickeʼs encephalopathy: the clinical features and their probable relationship to vitamin B deficiency. Quart J Med 1941; 10: 41-64
• 4 Ott M, Werneke U. Wernickeʼs encephalopathy – from basic science to clinical practice. Part 1: Understanding the role of thiamine. Ther Adv Psychopharmacol 2020; 10: 2045125320978106
• 5 Sechi G, Serra A. Wernickeʼs encephalopathy: new clinical settings and recent advances in diagnosis and management. Lancet Neurol 2007; 6: 442-455
• 6 Thomson AD, Cook CC, Touquet R. et al. The Royal College of Physicians report on alcohol: guidelines for managing Wernicke's encephalopathy in the accident and Emergency Department. Alcohol Alcohol 2002; 37: 513-521
• 7 Baumgartner G, Soyka M. Alcoholism – risk factors, diagnosis, therapy. MMW Fortschr Med 2014; 156: 65-69
• 8 Harper C, Gold J, Rodriguez M. et al. The prevalence of the Wernicke-Korsakoff syndrome in Sydney, Australia: a prospective necropsy study. J Neurol Neurosurg Psychiatry 1989; 52: 282-285
• 9 Sinha S, Kataria A, Kolla BP. et al. Wernicke Encephalopathy-Clinical Pearls. Mayo Clin Proc 2019; 94: 1065-1072
• 10 Ota Y, Capizzano AA, Moritani T. et al. Comprehensive review of Wernicke encephalopathy: pathophysiology, clinical symptoms and imaging findings. Jpn J Radiol 2020; 38: 809-820
• 11 Isen DR, Kline LB. Neuro-ophthalmic Manifestations of Wernicke Encephalopathy. Eye Brain 2020; 12: 49-60
• 12 Jahn K, Deutschlander A, Stephan T. et al. Supraspinal locomotor control in quadrupeds and humans. ProgBrain Res 2008; 171: 353-362
• 13 So YT. Wernicke encephalopathy. Aminoff MJ. Accessed July 26, 2022 at: https://www.uptodate.com/contents/wernicke-encephalopathy
• 14 Kopelman MD, Thomson AD, Guerrini I. et al. The Korsakoff syndrome: clinical aspects, psychology and treatment. Alcohol Alcohol 2009; 44: 148-154
• 15 Victor M, Adams RD, Collins GH. The Wernicke-Korsakoff syndrome. A clinical and pathological study of 245 patients, 82 with post-mortem examinations. Contemp Neurol Ser 1971; 7: 1-206
• 16 Smith H, McCoy M, Varughese K. et al. Thiamine Dosing for the Treatment of Alcohol-Induced Wernickeʼs Encephalopathy: A Review of the Literature. J Pharm Technol 2021; 37: 107-113
• 17 Dingwall KM KM, Delima JF, Binks P. et al. What is the optimum thiamine dose to treat or prevent Wernickeʼs encephalopathy or Wernicke–Korsakoff syndrome? Results of a randomized controlled trial. Alcohol Clin Exp Res 2022; 46: 1133-1147
• 18 Wrenn KD, Murphy F, Slovis CM. A toxicity study of parenteral thiamine hydrochloride. Ann Emerg Med 1989; 18: 867-870
• 19 McEntee WJ, Mair RG. Memory enhancement in Korsakoffʼs psychosis by clonidine: further evidence for a noradrenergic deficit. Ann Neurol 1980; 7: 466-470
• 20 OʼCarroll RE, Moffoot AP, Ebmeier KP. et al. Effects of fluvoxamine treatment on cognitive functioning in the alcoholic Korsakoff syndrome. Psychopharmacology (Berl) 1994; 116: 85-88
• 21 Cochrane M, Cochrane A, Jauhar P. et al. Acetylcholinesterase inhibitors for the treatment of Wernicke-Korsakoff syndrome – three further cases show response to donepezil. Alcohol Alcohol 2005; 40: 151-154