Coma in the Wernicke-Korsakoff syndrome

Area of Science:

• Neurology
• Internal Medicine

Background:

• Wernicke-Korsakoff syndrome is a severe neurological disorder often linked to chronic alcoholism and poor nutrition.
• It can manifest with diffuse encephalopathy, affecting consciousness and neurological function.

Observation:

• Four comatose patients with a history of alcoholism and prior neurological disease presented with Wernicke-Korsakoff syndrome.
• Three patients developed coma following nutritional support without vitamin supplementation.
• Clinical examination revealed diffuse encephalopathy, absent reflexes, and preserved pupillary light reflexes.

Findings:

• Parenteral thiamine administration led to improved consciousness in all patients.
• Despite treatment, three patients died, and one was left disabled, indicating a poor prognosis.
• The syndrome can present as a cause of coma in patients with a history of alcoholism.

Implications:

• Wernicke-Korsakoff syndrome requires greater recognition as a cause of coma.
• Empirical thiamine treatment should be considered for patients presenting with unexplained coma.
• Early diagnosis and intervention are critical, though survival and recovery remain challenging.