Re: Iatrogenic Wernicke-Korsakoff Syndrome

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Posted by CCF neuro MD# on February 20, 1998 at 16:05:30:

In Reply to: Iatrogenic Wernicke-Korsakoff Syndrome posted by Knusie on February 20, 1998 at 15:07:09:

: My family and I need help in finding a specialist in Wernicke-Korsakoff Syndrome (thiamine deficiency) caused by gastroplasty. We are in particular need of someone familiar with the mental symptoms of the disease, treatment and pros and cons of ECT for this condition. Also, what tests will reveal the brain damage, as MRI's, CT scans, glucose uptake CT have not shown any damage. She has gone from near comatose to awake and alert but with memory problems and gait problems (compounded by weakness from still not being able to eat more than maybe 600 calories a day). She has gotten worse in the last few weeks to the point where it is hard to get her to get out of bed, to respond, she is at times combative. But, when we are able to get her up, her condition improves. She regains her appetite (although can eat very little without pain and retching), she talks to us (but still seems apathetic), but she has delusions of seeing blood on the floor, thinking she is handing someone a bag when she's handing them nothing, memory problems, etc. We can't seem to keep her up and stimulated without working at it for an hour or so, and that is getting more and more difficult. Her physicians have never seen Wernicke-Korsakoff and refuse to believe she has it. They say she is a psychiatric patient and would like to perform ECT on her already damaged brain! This was first diagnosed by a neurologist in another hospital as thiamine deficiency. Any suggestions? Thank you for your time!

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I have reviewed published work on Wernicke -Korsakoff to see who is seeing
large numbers of patients with this problem. There is in fact surprisingly little
research on the condition in the US, however most of the publications
seem to come from Vanderbildt in Nashville , Tennessee, a Dr Martin in the
dept of psychiatry has published in this area.
Also in the University of Conneticut, Framington a Dr Hersh has published work
on the psychiatric aspests of the disorder.
It might be worth your while to contact these institutiona and have a preliminary
discussion before arranging a consultation.
As regards imaging and investigation the latest development in this area would
appear to be FLAIR MRI which gived good images of the lesions.

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