Matenda a Wernicke-Korsakoff

Matenda a Wernicke-Korsakoff ndi vuto laubongo chifukwa cha kuchepa kwa vitamini B1 (thiamine).

Matenda a Wernicke encephalopathy ndi matenda a Korsakoff ndizosiyanasiyana zomwe zimachitika limodzi. Zonsezi zimachitika chifukwa cha kuwonongeka kwa ubongo chifukwa cha kuchepa kwa vitamini B1.

Kusowa kwa vitamini B1 kumakhala kofala kwa anthu omwe ali ndi vuto lakumwa mowa. Zimakhalanso zofala kwa anthu omwe matupi awo samadya chakudya moyenera (malabsorption). Izi nthawi zina zimatha kupezeka ndi matenda osachiritsika kapena pambuyo pochepetsa thupi (bariatric).

Matenda a Korsakoff, kapena Korsakoff psychosis, amayamba kukhala matenda a Wernicke encephalopathy pomwe zizindikilo zimatha. Wernicke encephalopathy imayambitsa kuwonongeka kwaubongo m'malo am'munsi mwaubongo wotchedwa thalamus ndi hypothalamus. Korsakoff psychosis imachokera kuwonongeka kosatha kumadera aubongo okhudzidwa ndi kukumbukira.

Zizindikiro za matenda encephalopathy a Wernicke ndi awa:

• Kusokonezeka ndi kutayika kwa zochitika zamaganizidwe omwe amatha kupita kukomoka ndikufa
• Kutayika kwa kulumikizana kwa minofu (ataxia) komwe kumatha kubweretsa kugwedezeka kwamiyendo
• Masomphenya amasintha monga kuyenda kwa diso kosazolowereka (mayendedwe akutsogolo ndi kumbuyo otchedwa nystagmus), masomphenya awiri, chikope chagwa
• Kuchotsa mowa

Zizindikiro za matenda a Korsakoff:

• Kulephera kupanga zokumbukira zatsopano
• Kutaya kukumbukira, kumatha kukhala koopsa
• Kupanga nkhani (chisokonezo)
• Kuwona kapena kumva zinthu zomwe sizikupezeka (kuyerekezera zinthu m'maganizo)

Kuyesedwa kwa dongosolo lamanjenje / yaminyewa kumatha kuwonetsa kuwonongeka kwa mitsempha yambiri:

• Kusuntha kwamaso kosazolowereka
• Kutsika kapena kusakhazikika pamalingaliro
• Kuthamanga kwachangu (kugunda kwa mtima)
• Kuthamanga kwa magazi
• Kutentha kwa thupi
• Kufooka kwa minofu ndi atrophy (kutayika kwa minofu)
• Mavuto oyenda (gait) ndi mgwirizano

Munthuyo angawoneke kukhala wopanda chakudya. Mayesero otsatirawa amagwiritsidwa ntchito poyang'ana momwe munthu aliri ndi thanzi labwino:

• Serum albumin (imakhudzana ndi chakudya cha munthu aliyense)
• Maselo a vitamini B1
• Ntchito ya Transketolase m'maselo ofiira ofiira (amachepetsa anthu omwe ali ndi vuto la thiamine)

Mavitamini a chiwindi akhoza kukhala okwera mwa anthu omwe ali ndi mbiri yakumwa mowa mwauchidakwa kwanthawi yayitali.

Zina zomwe zingayambitse kuchepa kwa vitamini B1 ndizo:

• HIV / Edzi
• Khansa yomwe yafalikira mthupi lonse
• Kunyansidwa ndi kusanza kwambiri panthawi yapakati (hyperemesis gravidarum)
• Kulephera kwa mtima (mukamalandira chithandizo chamatenda a nthawi yayitali)
• Kutenga nthawi yayitali (IV) popanda kulandira zowonjezera ma thiamine
• Dialysis yayitali
• Matenda a chithokomiro okwera kwambiri (thyrotoxicosis)

MRI yaubongo ikhoza kuwonetsa kusintha kwa minofu yaubongo. Koma ngati matenda a Wernicke-Korsakoff akukayikiridwa, mankhwala ayenera kuyamba nthawi yomweyo. Kawirikawiri kuyesa kwa MRI sikofunikira.

Zolinga zamankhwala ndikuwongolera zizindikilo ndikupewa kuti matendawa asakulire. Anthu ena angafunike kukhala mchipatala msanga momwe angathandizire kuchepetsa zizindikilo.

Kuwunika ndi chisamaliro chapadera chitha kufunikira ngati munthu ali:

• Ndikakomoka
• Zovuta
• Osadziwa kanthu

Vitamini B1 nthawi zambiri imaperekedwa ndi jakisoni mumtsempha kapena minofu posachedwa. Izi zitha kukonza zizindikilo za:

• Kusokonezeka kapena kusokonezeka
• Zovuta ndi masomphenya ndi kuyenda kwamaso
• Kupanda kulumikizana kwa minofu

Vitamini B1 nthawi zambiri sichithandiza kukumbukira kukumbukira komanso kuzindikira komwe kumachitika ndi Korsakoff psychosis.

Kuletsa kumwa mowa kumatha kuletsa kugwiranso ntchito kwa ubongo ndikuwononga mitsempha. Chakudya choyenera, chopatsa thanzi chingathandize, koma sichilowa m'malo moletsa kumwa mowa.

Popanda chithandizo, matenda a Wernicke-Korsakoff akukulirakulira, ndipo atha kukhala wowopsa. Ndi chithandizo, ndizotheka kuwongolera zizindikilo (monga kuyenda kosagwirizana komanso zovuta zamasomphenya). Matendawa amathanso kuchepetsedwa kapena kuyimitsidwa.

Zovuta zomwe zingakhalepo ndi izi:

• Kuchotsa mowa
• Zovuta ndimayanjano amunthu kapena ochezera
• Kuvulala komwe kumachitika chifukwa cha kugwa
• Matenda osatha osokoneza bongo
• Kutha kwamuyaya kwa luso la kulingalira
• Kutaya mtima kwathunthu
• Atalikitsa moyo

Itanani odwala anu kapena pitani kuchipinda chodzidzimutsa ngati muli ndi zizindikiro za matenda a Wernicke-Korsakoff, kapena ngati mwapezeka kuti muli ndi vutoli ndipo matenda anu akukula kapena kubwerera.

Kusamwa mowa kapena kumwa pang'ono komanso kupeza zakudya zokwanira kumachepetsa chiopsezo chokhala ndi matenda a Wernicke-Korsakoff. Ngati woledzera saleka, mankhwala a thiamine komanso zakudya zabwino zimachepetsa mwayi wopeza vutoli, koma chiopsezo sichitha.

Korsakoff psychosis; Encephalopathy mowa; Encephalopathy - chidakwa; Matenda a Wernicke; Kugwiritsa ntchito mowa - Wernicke; Kuledzera - Wernicke; Kulephera kwa Thiamine - Wernicke

• Central dongosolo lamanjenje ndi zotumphukira zamanjenje
• Ubongo
• Nyumba zamaubongo

Koppel BS. Matenda okhudzana ndi thanzi komanso mowa. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: mutu 388.

Chifukwa chake YT. Kulephera kwa matenda amanjenje. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 85.