RESUMO
Wernicke's encephalopathy, a disorder with significant mortality and high morbidity, is common amongst alcohol-dependent patients. Thiamine deficiency appears to play a key role in its aetiology, and parenteral high-dose thiamine is effective in prophylaxis and treatment. Unfortunately, reports of rare anaphylactoid reactions have led to a dramatic reduction in the use of parenteral thiamine, and it is possible that this change in treatment has led, or will lead, to an increase in morbidity and mortality. There is a need for education of doctors who treat alcohol-dependent patients, in order to ensure appropriate use of parenteral thiamine in prophylaxis and treatment of this disorder.
Assuntos
Atitude do Pessoal de Saúde , Deficiência de Tiamina/tratamento farmacológico , Tiamina/efeitos adversos , Encefalopatia de Wernicke/tratamento farmacológico , Humanos , Infusões Intravenosas , Fatores de Risco , Taxa de Sobrevida , Tiamina/administração & dosagem , Deficiência de Tiamina/complicações , Deficiência de Tiamina/mortalidade , Reino Unido/epidemiologia , Encefalopatia de Wernicke/etiologia , Encefalopatia de Wernicke/mortalidadeRESUMO
In a prospective necropsy study, the prevalence of the Wernicke-Korsakoff syndrome (WKS) in Sydney, Australia was 2.1% of adults over the age of 15 years. The population studied encompassed a wide spectrum of socio-economic and cultural backgrounds. Abuse of alcohol appeared to be the major predisposing factor to the development of the WKS in cases which were adequately documented. This high prevalence rate is in line with other clinical and pathological Australian studies and provides additional support for the idea of prevention of the WKS by the use of thiamin supplements in the Australian diet in flour, bread and perhaps alcoholic beverages.