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2015 ; 17
(3
): ä Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Wernicke s Encephalopathy: Increasing Clinician Awareness of This Serious,
Enigmatic, Yet Treatable Disease
#MMPMID26644959
Flynn A
; Macaluso M
; D'Empaire I
; Troutman MM
Prim Care Companion CNS Disord
2015[]; 17
(3
): ä PMID26644959
show ga
OBJECTIVE: Undiagnosed and/or undertreated Wernicke's encephalopathy can result
in permanent brain damage, long-term institutionalization, and death. The purpose
of this article is to heighten clinical awareness of Wernicke's encephalopathy
and shed light on its diagnosis and treatment, which are often inconsistent due
to unclear diagnostic criteria and limited practice guidelines. An update on the
management of Wernicke's encephalopathy is presented and several case reports and
a quality improvement project from our hospital are described. DATA SOURCES:
PubMed, the Cochrane Database of Systematic Reviews, and PsycINFO were searched
for English-language articles published between January 1991 and January 2014
using combinations of the following keywords: Wernicke's encephalopathy,
diagnosis, treatment/guideline(s), and thiamine. STUDY SELECTION: The automated
search identified over 500 articles. A manual review of the related citations and
reference lists from articles of interest was also conducted. The articles
reviewed were chosen on the basis of author consensus and because they
represented expert opinion or the highest quality of evidence available. RESULTS:
Diagnostic criteria are reviewed in this article and should be used to diagnose
Wernicke's encephalopathy with high sensitivity and specificity. The European
Federation of Neurologic Societies and the Royal College of Physicians issued
national guidelines for the diagnosis, prevention, and treatment of Wernicke's
encephalopathy. No benchmark national guidelines for treating Wernicke's
encephalopathy exist in the United States. CONCLUSIONS: Whenever Wernicke's
encephalopathy is suspected, treatment should be initiated immediately with
intravenous thiamine because oral thiamine is inadequate for preventing permanent
brain damage. An adequate dose of intravenous thiamine administrated in a timely
manner is a safe and life-saving treatment for Wernicke's encephalopathy that
could preserve brain cells and function.
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