Isifo seWernicke-Korsakoff

Isifo seWernicke-Korsakoff sisifo sokuphazamiseka kwengqondo ngenxa yokusilela kwe-vitamin B1 (thiamine).

I-Wernicke encephalopathy kunye ne-Korsakoff syndrome ziimeko ezahlukeneyo ezihlala zenzeka kunye. Zombini zibangelwa kukonakala kwengqondo okubangelwa kukungabikho kwe-vitamin B1.

Ukungabikho kwe-vitamin B1 kuqhelekileyo kubantu abanengxaki yokusebenzisa utywala. Kuqhelekile nakubantu abanemizimba engakuthathi ukutya ngokufanelekileyo (malabsorption). Oku ngamanye amaxesha kunokwenzeka ngesifo esinganyangekiyo okanye emva kovavanyo lokwehla kobunzima (i-bariatric).

I-Korsakoff syndrome, okanye i-Korsakoff psychosis, ihlala ikhula njenge-Wernicke encephalopathy njengoko iimpawu zihamba. I-Wernicke encephalopathy ibangela ukonakala kwengqondo kwiindawo ezisezantsi kwengqondo ezibizwa ngokuba yi-thalamus kunye ne-hypothalamus. Isifo sengqondo seKorsakoff sisiphumo somonakalo osisigxina kwiindawo zobuchopho ezichaphazelekayo kwimemori.

Iimpawu zeWernicke encephalopathy zibandakanya:

• Ukudideka kunye nokuphulukana nomsebenzi wengqondo onokuthi uqhubele phambili ukuya kwi-coma nasekufeni
• Ukuphulukana nokulungelelaniswa kwemisipha (ataxia) enokubangela ukungcangcazela komlenze
• Umbono utshintsha njengokuhamba kwamehlo okungaqhelekanga (iintshukumo ezibuyela umva naphambili ezibizwa ngokuba yi-nystagmus), umbono ophindwe kabini, ukuwa kwejwabu leso
• Ukurhoxiswa kotywala

Iimpawu zesifo seKorsakoff:

• Ukungakwazi ukwenza iinkumbulo ezintsha
• Ukuphulukana nenkumbulo, kunokuba nzima
• Ukwenza amabali (ukudibanisa)
• Ukubona okanye ukuva izinto ezingekhoyo (ukubona izinto ezingekhoyo)

Ukuvavanywa kwenkqubo yemithambo-luvo / yemisipha kunokubonisa ukonakala kwiinkqubo ezininzi zemithambo-luvo:

• Ukuhamba kwamehlo okungaqhelekanga
• Ukuhla kweempawu ezinqabileyo okanye ezingaqhelekanga
• Ukukhawuleza kwentliziyo (ukubetha kwentliziyo)
• Uxinzelelo lwegazi oluphantsi
• Ubushushu obuphantsi bomzimba
• Ubuthathaka bemisipha kunye ne-atrophy (ukulahleka kobunzima bezicubu)
• Iingxaki ngokuhamba (ukuhamba) kunye nokulungelelanisa

Umntu angabonakala engondlekanga kakuhle. Ezi mvavanyo zilandelayo zisetyenziselwa ukukhangela inqanaba lomntu lesondlo:

• I-serum albumin (inxulumene nesondlo somntu ngokubanzi)
• Amanqanaba e-vitamin B1 yeSerum
• Umsebenzi weTransketolase kwiiseli ezibomvu zegazi (kuncitshisiwe kubantu abanesiphene se-thiamine)

Ii-enzyme zesibindi zinokuphakama kubantu abanembali yokusetyenziswa gwenxa kotywala ixesha elide.

Ezinye iimeko ezinokubangela ukusilela kwe-vitamin B1 zibandakanya:

• Intsholongwane kaGawulayo / uGawulayo
• Umhlaza osasazeke emzimbeni wonke
• Isicaphucaphu esigqithisileyo kunye nokugabha ngexesha lokukhulelwa (hyperemesis gravidarum)
• Ukungaphumeleli kwentliziyo (xa uphathwa ngonyango lwe-diuretic yexesha elide)
• Ixesha elide lonyango (IV) ngaphandle kokufumana izongezo ze-thiamine
• I-dialysis yexesha elide
• Amanqanaba aphezulu kakhulu e-thyroid (thyrotoxicosis)

Ingqondo ye-MRI inokubonisa utshintsho kwizicubu zobuchopho. Kodwa ukuba kurhanelwa isifo seWernicke-Korsakoff, unyango kufuneka luqale kwangoko. Ngokwesiqhelo uvavanyo lwe-MRI lobuchopho aludingeki.

Iinjongo zonyango kukulawula iimpawu kunye nokukhusela ukungahambi kakuhle. Abanye abantu banokufuna ukuhlala esibhedlele kwangethuba kwimeko yokunceda ukulawula iimpawu.

Ukubeka iliso kunye nokunyamekela ngokukodwa kunokufuneka ukuba umntu:

• Kwikhoma
• Iingxaki
• Akukho zingqondweni

I-Vitamin B1 ihlala inikwa ngenaliti emthanjeni okanye kwimisipha ngokukhawuleza. Oku kunokuphucula iimpawu ze:

• Ukudideka okanye ukuphambana
• Ubunzima ngombono kunye nokuhamba kwamehlo
• Ukungabikho kolungelelwaniso lwezihlunu

I-Vitamin B1 ihlala ikuphucula ukulahleka kwememori kunye nengqondo eyenzeka nge-Korsakoff psychosis.

Ukuyeka ukusetyenziswa kotywala kunokuthintela ukulahleka okungakumbi kokusebenza kwengqondo kunye nomonakalo kwimithambo-luvo. Ukutya okunesondlo, okunesondlo kunokunceda, kodwa ayisiyiyo indawo yokumisa ukusetyenziswa kotywala.

Ngaphandle konyango, iWernicke-Korsakoff syndrome iya isiba mandundu, kwaye inokubusongela ubomi. Ngonyango, kunokwenzeka ukulawula iimpawu (njengokuhamba okungahambelaniyo kunye nobunzima bokubona). Esi sifo sinokucothiswa okanye simiswe.

Iingxaki ezinokubangela zibandakanya:

• Ukurhoxiswa kotywala
• Ubunzima ngokusebenzisana nomntu okanye intlalontle
• Ukwenzakala okubangelwa kukuwa
• Isisigxina se-neuropathy
• Ukupheliswa okungapheliyo kwezakhono zokucinga
• Ukupheliswa okungapheliyo kwememori
• Ubomi obufutshane

Fowunela umboneleli wakho wezempilo okanye uye kwigumbi likaxakeka ukuba uneempawu ze-Wernicke-Korsakoff syndrome, okanye ukuba ufumene ukuba unale meko kwaye iimpawu zakho ziya zisiba mbi okanye zibuye.

Ukungaseli tywala okanye ukusela ngokumodareyitha kunye nokufumana ukutya okwaneleyo ukunciphisa umngcipheko wokuphuhlisa isifo seWernicke-Korsakoff. Ukuba umntu osela kakhulu akasayi kuyeka, izongezo ze-thiamine kunye nokutya okufanelekileyo kunokunciphisa amathuba okufumana le meko, kodwa umngcipheko awupheliswa.

Ingqondo yengqondo yeKorsakoff; Encephalopathy butywala; Ukunyanga kwengqondo - utywala; Isifo sikaWernicke; Ukusetyenziswa kotywala - iWernicke; Utywala - iWernicke; Ukunqongophala kweTyamine - iWernicke

• Inkqubo ye-nervous central kunye ne-peripheral system
• Ingqondo
• Ulwakhiwo lobuchopho

IKoppel BS. Iziphazamiso ezinxulumene nesondlo kunye notywala. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 388.

Ke YT. Ukusilela kwezifo kwinkqubo yemithambo-luvo. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 85.