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Cited by 253Alcoholism and Thiamine DeficiencyThallium and Germanium StudiesBiochemical Acid Research Studies

Wernicke-Korsakoff-syndrome: Under-recognized and under-treated

Isenberg-Grzeda, Elie, Kutner, Haley E., Nicolson, Stephen E.·2012·Psychosomatics
DOI 10.1016/j.psym.2012.04.008
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Abstract

Background Wernicke-Korsakoff syndrome (WKS) is a well described syndrome of neurological and cognitive problems that comprises both Wernicke's encephalopathy (WE) and Korsakoff syndrome (KS). WE is an acute neuropsychiatric disorder caused by thiamine deficiency. KS is a chronic consequence of thiamine deficiency with prominent impairment in memory formation.Method The authors review the literature on the pathophysiology, presentation, and treatment of WKS, focusing on the acute identification and treatment of WE.Results Most cases of WE are missed by clinicians, likely because patients do not present with the classic signs associated with the condition. Attaining high serum levels of thiamine during treatment may be important to restore cognitive function as quickly as possible, though the exact dosing and route needed for effective treatment is unknown. Data indicates that the administration of intravenous (IV) thiamine has little risk.Conclusion In order to prevent this potentially devastating disease, physicians should have a high index of suspicion for WKS and dose thiamine accordingly.

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  • Early correction of thiamine deficiency can fully reverse symptoms and prevent brain damage; persistent deficiency causes permanent brain damage and irreversible cognitive dysfunction.

    “When thiamine deficiency is corrected early enough, symptoms can be fully reversed and significant brain damage can be prevented. However permanent brain damage and irreversible cognitive dysfunction will occur if thiamine deficiency persists and this can be critical as encephalopathies linked to thiamine deficiency remain largely undiagnosed [141].”

    From Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence (2020) · cites this paper as [141]

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Authors
Isenberg-Grzeda, E., Kutner, H. E., & Nicolson, S. E.
Affiliations
  • Yeshiva University (US)
  • Albert Einstein College of Medicine (US)
Corresponding author
Nicolson, Stephen E.
ORCID
Nicolson, Stephen E.
Venue
Psychosomatics
Publisher
Elsevier BV
Published
2012-11
Volume
53
Issue
6
Pages
507-516
ISSN
0033-3182 (ISSN-L)
DOI
10.1016/j.psym.2012.04.008
OpenAlex
W2134369415
Cited by
253
References
86
Citations by year
2026: 14 · 2025: 20 · 2024: 20 · 2023: 27 · 2022: 24 · 2021: 23 · 2020: 18 · 2019: 17 · 2018: 24 · 2017: 17 · 2016: 15 · 2015: 12 · 2014: 14 · 2013: 8
FWCI
1.52
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Psychosomatics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Neurology › Alcoholism and Thiamine Deficiency
  • Physical Sciences › Environmental Science › Pollution › Thallium and Germanium Studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Biochemical Acid Research Studies
Keywords
Wernicke-Korsakoff syndrome, Wernicke's encephalopathy, Korsakoff syndrome, thiamine deficiency, thiamine supplementation, intravenous thiamine, memory impairment, underdiagnosis, pathophysiology, cognitive function
MeSH terms
Diagnosis, Differential, Humans, Injections, Intravenous, Thiamine, Thiamine Deficiency, Disease Progression, Korsakoff Syndrome, Delayed Diagnosis

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