RESUMEN
The authors report 13 cases of Gayet-Wernicke's encephalopathy observed in 13 patients of a refugee population. 11 presented the classical triad: oculomotor signs, cerebral ataxia and state of confusion and in 2 patients, only 2 symptoms were noted. The etiological factors: chronic alcoholism, malnutrition, uncontrollable vomiting, HIV and tuberculosis were identified. The outcome was evaluated on the basis of the disappearance of symptoms after treatment with 500 mg of thiamine in 7 patients, 1 death and 5 patients progressed toward Korsakoff amnesic syndrome.
Asunto(s)
Encefalopatía de Wernicke/patología , Alcoholismo/complicaciones , Confusión/etiología , Guinea , Infecciones por VIH/complicaciones , Humanos , Refugiados , Tasa de Supervivencia , Sobrevivientes , Tiamina/uso terapéutico , Tuberculosis/complicaciones , Encefalopatía de Wernicke/tratamiento farmacológico , Encefalopatía de Wernicke/mortalidad , Encefalopatía de Wernicke/psicologíaRESUMEN
Cardiovascular and neurological manifestations associated with thiamine deficiency in Guinean prisons are common but not reported.We performed a prospective study of 38 cases related to vitamin B1 deficiency over a period of 4 years. In this population, the literature of traditional data gathered: frequency peak after thirty (92.6%) and clear representation male (sex ratio M/F: 18/1). The clinical symptomatology remains essentially dominated by sensorimotor polyneuropathy and pure sensory (52.2%), overall heart failure (31.5%) and to a lesser degree by Gayet Wernicke's encephalopathy (7.8%) and shoshin beriberi with severe evolution (5.2%). The study of nutritional status by body mass index (BMI) of the World Health Organization, by the criteria of Detsky and biological markers including albumin, shows that these patients are severely malnourished.
Asunto(s)
Prisioneros/estadística & datos numéricos , Deficiencia de Tiamina/diagnóstico , Deficiencia de Tiamina/epidemiología , Adulto , Beriberi/diagnóstico , Beriberi/epidemiología , Estudios de Cohortes , Diagnóstico Diferencial , Femenino , Guinea/epidemiología , Humanos , Masculino , Desnutrición/diagnóstico , Desnutrición/epidemiología , Persona de Mediana Edad , Fenotipo , Prisiones/estadística & datos numéricos , Encefalopatía de Wernicke/diagnóstico , Encefalopatía de Wernicke/epidemiologíaRESUMEN
Neurologic disorders related to chronic alcoholism in traditional areas of Guinea are frequent, but reports about them are rare. We conducted the first study in Guinea on this subject and retrospectively collected 42 cases of neurologic manifestations related to alcoholism over a 7-year period. The standard findings of the literature were confirmed in our population: peak frequency after the age of 40 years (82.8%) and clear male overrepresentation (M/F sex ratio: 13/1). All the standard signs and symptoms are reported, with a clear predominance of alcoholic polyneuropathy and hepatic encephalopathy. The study of nutritional status by both body mass index (BMI) and the Detsky criteria showed that these patients were severely malnourished. The brain MRI was a crucial contribution for diagnosing the standard central nervous system complications of alcoholism: Gayet Wernicke encephalopathy, Marchiafava-Bignami disease, Korsakoff syndrome, central pontine myelinolysis, and cerebellar degeneration.