Yogesh Jagannath Pokale ¹, Sunil Govind Gupte ¹

Affiliations
1 Dr. Vasantrao Pawar Medical College, Hospital and Research centre, Vasantdada nagar, Adgaon, Nashik-422003, IN

Abstract

Background: Alcohol use is one of the most serious problems in public health and the Wernicke–Korsakoff Syndrome is one of the gravest consequences of alcoholism. Post–mortem studies suggest that Wernicke–Korsakoff Syndrome occurs in 12.5% of dependent drinkers and in 2% of the general population. Korsakoff Syndrome is an amnestic disorder generally followed by untreated Wernicke’s Encephalopathy. Wernicke–Korsakoff Syndrome is most commonly a post–mortem diagnosis. Aim and Objective: To report a case of Korsakoff Syndrome since the clinical presentation is often undiagnosed or misdiagnosed. Case description: 50 year old male, drinking heavily since 25 years presented with complaints of forgetfulness, talking irrelevantly since last 18 months. Patient developed symptoms of confusion, ataxia, and altered behaviour 2 years back, for which he was treated as a case of encephalitis and not treated with thiamine. He later progressed to show symptoms of amnesia. On examination, patient showed recent memory deficit with anterograde and variable retrograde amnesia with confabulations. Neurological examination revealed absent deep tendon reflexes and signs of peripheral neuropathy. MRI brain showed global cortical atrophy. The sequence of events in this case study demonstrates the possible effects of long term alcohol use, namely Wernicke–Korsakoff Syndrome. Highlights of the medical model of Wernicke–Korsakoff Syndrome will be subsequently presented. Lastly, suggestions for treatment and prevention of further damage will be discussed.

Keywords

Chronic Alcoholism, Wernicke’s Encephalopathy, Amnestic Syndrome, Thiamine Deficiency

Full Text

   

Sunil Govind Gupte ¹, Aishwary Raj ²

Affiliations
1 Professor and Head, Department of Psychiatry, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Former PG Resident, Department of Psychiatry, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 42203, Maharashtra, IN

Abstract

Introduction: According to World Health Organization (WHO), cerebrovascular stroke is the second leading cause of death and disability all over the world. Infarct alters brain function which leads to neuropsychiatric sequela. Psychiatric morbidities are common in stroke-survivor cohorts and are associated with increased morbidity and mortality. Aims and Objectives: The present study was conducted in a tertiary care hospital to understand the different psychiatric morbidities in patients with cerebrovascular accidents (stroke). Material and Methods: 150 stroke survivors were included in the study after they satisfied the eligibility criteria. Mini International Neuropsychiatric Interview (MINI) 7.0.0 was applied to diagnose the psychiatric illness in the patients. Results: Out of 150 patients 79 patients (52.66%) had psychiatric illness. Out of the 150 patients, 50 patients (33.33%) had Major Depressive Disorder, 24 patients (16%) had Generalized Anxiety Disorder (GAD), 3 patients (2%) were diagnosed with psychotic disorder whereas 2 Patients (1.33%) had social phobia. Out of which 50 patients (33.33%) were having Major Depressive Disorder (MDD), 24 patients (16%) were having Generalized Anxiety Disorder, 3 patients (2%) were having psychotic disorder and 2 Patients (1.33%) were having Social phobia. Most of the patients had ischemic type of stroke (133 patients) , left sided lesion (88 patients) being the most common. Conclusion: Major depressive disorder was the most common psychiatric illness followed by generalized anxiety disorder. The psychiatric illness was not associated with type of stroke and side of lesion.

Keywords

Cerebrovascular Stroke, Generalized Anxiety Disorder, Major Depressive Disorder, Social Phobia

Full Text