Lefu la Wernicke-Korsakoff

Wernicke-Korsakoff syndrome ke lefu la boko ka lebaka la khaello ea vithamine B1 (thiamine).

Wernicke encephalopathy le lefu la Korsakoff ke maemo a fapaneng a atisang ho etsahala hammoho. Ka bobeli li bakoa ke tšenyo ea boko e bakiloeng ke khaello ea vithamine B1.

Ho haella ha vithamine B1 ho atile ho batho ba nang le bothata ba tšebeliso ea joala. Ho tloaelehile hape ho batho bao 'mele ea bona e sa moneng lijo hantle (malabsorption). Sena se ka etsahala ka linako tse ling ka bokuli bo sa foleng kapa kamora ho buuoa ka boima ba 'mele (bariatric).

Lefu la Korsakoff, kapa lefu la kelello la Korsakoff, le atisa ho ba joalo ka lefu la Wernicke encephalopathy ha matšoao a fela. Wernicke encephalopathy e baka tšenyo ea boko likarolong tse tlase tsa boko tse bitsoang thalamus le hypothalamus. Korsakoff psychosis e bakoa ke tšenyo e sa feleng libakeng tsa boko tse amehang mohopolong.

Matšoao a Wernicke encephalopathy a kenyelletsa:

• Pherekano le tahlehelo ea ts'ebetso ea kelello e ka tsoelang pele ho ea coma le lefu
• Ho lahleheloa ke khokahano ea mesifa (ataxia) e ka bakang ho thothomela ha leoto
• Pono e fetoha joalo ka motsamao o sa tloaelehang oa mahlo (ho sisinyeha ho ea pele le morao ho bitsoang nystagmus), pono e habeli, ho koala mahlo
• Ho tlohela joala

Matšoao a lefu la Korsakoff:

• Ho sitoa ho theha mehopolo e mecha
• Ho lahleheloa ke mohopolo, ho ka ba matla
• Ho iqapela lipale (pherekano)
• Ho bona kapa ho utloa lintho tse seng teng moo (lipono)

Ho hlahlojoa ha methapo ea methapo / mesifa ho ka bontša tšenyo ea methapo e mengata ea methapo:

• Tsamaiso e sa tloaelehang ea mahlo
• Maikutlo a fokotsehileng kapa a sa tloaelehang
• Ho otla ka potlako (lebelo la pelo)
• Khatello ea mali e tlase
• Mocheso oa 'mele o tlase
• Bofokoli ba mesifa le ho felloa ke matla
• Mathata ka ho tsamaea (gait) le khokahano

Motho a ka bonahala a sa fepeha hantle. Liteko tse latelang li sebelisoa ho lekola boemo ba phepo ea motho:

• Serum albumin (e amana le phepo e akaretsang ea motho)
• Litekanyo tsa Serum vithamine B1
• Ketsahalo ea Transketolase lisele tse khubelu tsa mali (e fokotsehile ho batho ba nang le khaello ea thiamine)

Li-enzyme tsa sebete li ka ba holimo ho batho ba nang le nalane ea tšebeliso e mpe ea joala ea nako e telele.

Maemo a mang a ka bakang khaello ea vithamine B1 a kenyelletsa:

• HIV / AIDS
• Kankere e hasaneng hohle 'meleng
• Ho nyekeloa ke pelo le ho hlatsa ka matla nakong ea bokhachane (hyperemesis gravidarum)
• Ho hloleha ha pelo (ha ho phekoloa ka kalafo ea nako e telele ea diuretic)
• Nako e telele ea kalafo ea methapo (IV) ntle le ho fumana li-supplements tsa thiamine
• Dialysis ea nako e telele
• Tekanyo e phahameng haholo ea lihomone tsa qoqotho (thyrotoxicosis)

MRI ea boko e ka bonts'a liphetoho liseleng tsa boko. Empa haeba ho belaelloa lefu la Wernicke-Korsakoff, kalafo e lokela ho qala hanghang. Hangata tlhahlobo ea MRI ea boko ha e hlokahale.

Morero oa kalafo ke ho laola matšoao le ho thibela lefu lena hore le se ke la mpefala. Batho ba bang ba kanna ba hloka ho lula sepetlele pele ho boemo ho thusa ho laola matšoao.

Tlhokomelo le tlhokomelo e khethehileng li ka hlokahala haeba motho ke:

• Ka ho akheha
• Lethargic
• Ha a tsebe letho

Vithamine B1 hangata e fanoa ka ente ka methapong kapa mesifa kapele kamoo ho ka khonehang. Sena se ka ntlafatsa matšoao a:

• Pherekano kapa pherekano
• Mathata a nang le pono le motsamao oa mahlo
• Ho hloka tšebelisano ea mesifa

Vithamine B1 hangata ha e ntlafatse ho lahleheloa ke mohopolo le kelello tse hlahang ka lefu la kelello la Korsakoff.

Ho emisa tšebeliso ea joala ho ka thibela tahlehelo e ngata ea ts'ebetso ea boko le tšenyo ea methapo. Lijo tse nang le phepo e nepahetseng le tse matlafatsang li ka thusa, empa ha li nke sebaka sa ho emisa tšebeliso ea joala.

Ntle le kalafo, lefu la Wernicke-Korsakoff le ntse le mpefala hanyane ka hanyane, mme le ka beha bophelo kotsing. Ka kalafo ho a khonahala ho laola matšoao (joalo ka motsamao o sa hokahaneng le mathata a pono). Lefu lena le ka fokotsoa kapa la emisoa.

Mathata a ka hlahang a kenyelletsa:

• Ho tlohela joala
• Bothata le tšebelisano ea motho ka mong kapa ea sechaba
• Kotsi e bakoang ke ho oa
• Pherekano e sa feleng ea joala
• Ho felloa ke nako ea ho nahana
• Ho lahleheloa ke mohopolo ka ho sa feleng
• Nako e khutsufalitsoeng ea bophelo

Bitsa mofani oa tlhokomelo ea bophelo kapa u ee kamoreng ea maemo a tšohanyetso haeba u na le matšoao a lefu la Wernicke-Korsakoff, kapa haeba u fumanoe u e-na le boemo boo 'me matšoao a hau a mpefala kapa a khutla.

Ho se noe joala kapa ho noa ka tekano le ho fumana phepo e lekaneng ho fokotsa menyetla ea ho ba le lefu la Wernicke-Korsakoff. Haeba motho ea noang haholo a sa tlohele, li-supplements tsa thiamine le phepo e nepahetseng li ka fokotsa monyetla oa ho fumana boemo bona, empa kotsi ha e felisoe.

Korsakoff psychosis; Joala encephalopathy; Encephalopathy - joala; Lefu la Wernicke; Tšebeliso ea joala - Wernicke; Bokhoba ba tahi - Wernicke; Ho haella ha thiamine - Wernicke

• Sisteme ea methapo e bohareng le methapo ea methapo
• Boko
• Mehaho ea boko

Koppel BS. Mathata a amanang le phepo e nepahetseng le a amanang le joala. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 388.

Kahoo YT. Khaello mafu a tsamaiso ea methapo. Ka: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, bahlophisi. Neurology ea Bradley ho Tloaelo ea Bongaka. La 7th. Philadelphia, PA: Elsevier; 2016: khaolo ea 85.