Wernicke-Korsakoff chirwere

Wernicke-Korsakoff syndrome chirwere chehuropi nekuda kwekushomeka kwevhitamini B1 (thiamine).

Wernicke encephalopathy uye Korsakoff syndrome mamiriro akasiyana anowanzoitika pamwechete. Zvese zviri zviviri zvinokonzerwa nekukuvara kwehuropi kunokonzerwa nekushaikwa kwevhitamini B1.

Kushaikwa kwevhitamini B1 kunowanzoitika kune vanhu vane doro rekushandisa kusagadzikana. Zvakajairikawo kune vanhu vane miviri isingatore chikafu zvakanaka (malabsorption). Izvi zvinogona dzimwe nguva kuitika nechirwere chisingaperi kana mushure mekurema-kurasikirwa (bariatric) kuvhiyiwa.

Korsakoff syndrome, kana Korsakoff psychosis, inotanga kukura seWernicke encephalopathy sezvo zviratidzo zvoenda. Wernicke encephalopathy inokonzeresa kukuvara kwehuropi munzvimbo dzakaderera dzehuropi dzinodaidzwa kunzi thalamus uye hypothalamus. Korsakoff psychosis inokonzeresa kubva mukukuvara kusingaperi kunzvimbo dzehuropi dzakabatanidzwa nendangariro.

Zviratidzo zveWernicke encephalopathy zvinosanganisira:

• Kuvhiringidzika uye kurasikirwa kwezvepfungwa zviitiko zvinogona kufambira mberi kusvika pakoma uye kufa
• Kurasikirwa kwekubatana kwemhasuru (ataxia) iyo inogona kukonzera kudedera kwegumbo
• Chiono chinoshanduka senge chisina kujairika kufamba kweziso (kumashure nekumashure kufamba kunodaidzwa kunzi nystagmus), kuona kaviri, kufinyama kwemaziso
• Kunwa doro

Zviratidzo zveKorsakoff syndrome:

• Kutadza kuumba ndangariro nyowani
• Kurasikirwa kwendangariro, kunogona kuva kwakanyanya
• Kugadzira nyaya (kuvhiringidza)
• Kuona kana kunzwa zvinhu zvisipo chaizvo (kufungidzira)

Kuongororwa kwenzira / tsandanyama system inogona kuratidza kukuvara kune akawanda masisitimu etsinga:

• Kufambisa kwemaziso kusingaite
• Kupera kana kusagadzikana kwekufungisisa
• Kukurumidza kupisa (kurova kwemoyo)
• Kuderera kweropa
• Tembiricha yemuviri yakaderera
• Tsvina kushaya simba uye atrophy (kurasikirwa kwemasuru mashoma)
• Matambudziko nekufamba (gait) nekubatana

Munhu wacho anogona kuoneka asina kudya zvakanaka. Iyi bvunzo inotevera inoshandiswa kutarisa huwandu hwemunhu hutano:

• Serum albumin (inoenderana neyakajairika kudya kwemunhu)
• Serum vhitamini B1 mazinga
• Transketolase chiitiko mumasero matsvuku eropa (akaderedzwa mune vanhu vane thiamine kushomeka)

Chiropa enzymes inogona kunge yakakwira kune vanhu vane nhoroondo yekureba-kwenguva refu kunwa doro zvisina kufanira.

Mimwe mamiriro ezvinhu anogona kukonzera kushomeka kwevhitamini B1 anosanganisira:

• HIV / AIDS
• Cancers dzakapararira mumuviri wese
• Kunyunyuta kwakanyanya uye kurutsa panguva yekuzvitakura (hyperemesis gravidarum)
• Kutadza kwemoyo (kana uchirapwa neakareba-diuretic therapy)
• Nguva refu yekurapa (IV) kurapa pasina kugamuchira thiamine yekuwedzera
• Yenguva refu dialysis
• Yakanyanya kwazvo thyroid thyroid mazinga (thyrotoxicosis)

Uropi MRI inogona kuratidza shanduko munyama dzehuropi. Asi kana Wernicke-Korsakoff syndrome achifungidzirwa, kurapwa kunofanira kutanga nekukurumidza. Kazhinji uropi MRI bvunzo haidiwe.

Zvinangwa zvekurapa ndezvekudzora zviratidzo uye kudzivirira kusagadzikana kutowedzera. Vamwe vanhu vangangoda kugara muchipatara kutanga mune mamiriro ekubatsira kudzora zviratidzo.

Kuongorora uye kutarisirwa kwakakosha kunogona kudikanwa kana munhu ari:

• Mukoma
• Lethargic
• Kusaziva

Vitamini B1 inowanzo kupihwa jekiseni mumutsipa kana mhasuru nekukurumidza sezvazvinogona. Izvi zvinogona kuvandudza zviratidzo zve:

• Kuvhiringidzika kana delirium
• Dambudziko nekuona uye kufamba kweziso
• Kusava nekubatana kwetsandanyama

Vitamin B1 kazhinji haigadzirise kurasikirwa kwendangariro nehungwaru zvinoitika neKorsakoff psychosis.

Kumisa kunwa doro kunogona kudzivirira kurasikirwa kwakawanda kwehuropi kushanda uye kukuvara kwemitsipa. Kudya kwakadzikama, kunovaka kunogona kubatsira, asi hakusi kutsiva kumisa kunwa doro.

Pasina kurapwa, Wernicke-Korsakoff syndrome inowedzera kuwedzera, uye inogona kutyisidzira hupenyu. Nekurapa, zvinokwanisika kudzora zviratidzo (senge kusabatana uye kufamba uye kuona kunetsa). Dambudziko iri rinogona zvakare kudzikiswa kana kumiswa.

Matambudziko anogona kuguma anosanganisira:

• Kunwa doro
• Dambudziko nekudyidzana kwehukama kana hwehukama
• Kukuvara kunokonzerwa nekudonha
• Permanent alcohol alcohol neuropathy
• Kurasikirwa zvachose kweunyanzvi hwekufunga
• Kurasikirwa zvachose kwechiyeuchidzo
• Yakafupiswa nguva yeupenyu

Fonera wako mupi wezvehutano kana kuenda kuchimbichimbi kamuri kana iwe uine zviratidzo zveWernicke-Korsakoff syndrome, kana kana iwe wakamboonekwa uine mamiriro uye zviratidzo zvako zvinowedzera kana kudzoka.

Kusanwa doro kana kunwa zvine mwero uye kuwana chikafu chakaringana kunoderedza njodzi yekuvandudza chirwere cheWernicke-Korsakoff. Kana chidhakwa chikasasiya, thiamine inowedzera uye kudya kwakanaka kunogona kudzikisira mukana wekuwana mamiriro aya, asi njodzi haina kubviswa.

Korsakoff psychosis; Doro encephalopathy; Encephalopathy - chidhakwa; Chirwere cheWernicke; Doro kushandisa - Wernicke; Kudhakwa - Wernicke; Kushayikwa kweTiamine - Wernicke

• Central nervous system uye yekumusoro tsinga system
• Ubongo
• Zvimiro zvehuropi

Koppel BS. Hutano uye doro-zvine hukama neurologic kusagadzikana. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 388.

Saka YT. Kushomeka kwezvirwere zvehurongwa hwemitsipa. Mune: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology muClinical Dzidzira. 7th ed. Philadelphia, PA: Elsevier; 2016: chits 85.