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Dementia
Published in Henry J. Woodford, Essential Geriatrics, 2022
Wernicke–Korsacoff syndrome is caused by thiamine (vitamin B1) deficiency. The Wernicke stage is usually the precursor and has the clinical characteristics of ophthalmoplegia, ataxia and delirium. The Korsacoff stage usually, but not always, follows one or more episodes of Wernicke syndrome. This is a prolonged amnesic disorder affecting the ability to form new memories. It often causes confabulation. The pathological finding is of haemorrhagic necrosis of the mamillary bodies. Marchiafava–Bignami disease is due to acute demyelination of the corpus callosum. It was first described in middle-aged Italian men who drank excessive quantities of red wine. Associated with the dementia are seizures and inter-hemispheric disconnection. In cases of alcohol-related dementia, cognition may improve, or at least stabilise, with thiamine replacement and abstinence.
Paper 3
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
The imaging has features of chronic excess alcohol intake with generalised volume loss and atrophy of the anterior cerebellar vermis. The abnormal MRI signal in the corpus callosum is indicative of Marchiafava-Bignami disease. In the acute stage of the disease there is oedema and over time this progresses to necrosis and atrophy. It often starts in the body of the corpus callosum and progresses to the genu and splenium. Treatment is with B vitamins.
Valentin Magnan and Sergey Korsakov: French and Russian pioneers in the study of alcohol abuse
Published in Journal of the History of the Neurosciences, 2018
Toward the end of the nineteenth and the beginning of the twentieth century, the main alcohol-related neurological syndromes were outlined: Wernicke encephalopathy (Wernicke, 1881), Korsakov syndrome (Korsakov, 1887b), and Marchiafava-Bignami disease (Marchiafava & Bignami, 1903). Wernicke’s encephalopathy, also called Wernicke’s disease, refers to the presence of neurological symptoms caused by biochemical lesions of the central nervous system after exhaustion of B-vitamin reserves, in particular vitamin B1, thiamine. Classically, German neurologist Karl Wernicke (1848–1905) encephalopathy is characterized by the triad ophthalmoplegia, ataxia, and confusion. Korsakov’s syndrome is a manifestation of Wernicke’s encephalopathy. The major symptoms are anterograde amnesia, retrograde amnesia, confabulation, minimal content in communication, lack of insight, and apathy. Finally, Marchiafava-Bignami disease (MBD) is a rare condition characterized by demyelination of the corpus callosum.