Wernicke-Korsakoff syndrome in head injury: a missed insult.
A survey of the use of thiamine in patients at risk from Wernicke-Korsakoff syndrome (WKS) in Scottish specialist neurosurgical units, and a 2-year retrospective study of 218 at-risk patients admitted to a regional neurosurgical unit with a head injury were undertaken. Although responses to the survey indicated otherwise, the study revealed that there was no consistent practice regarding thiamine administration. Overall, 20.6% of patients received thiamine, with an alcohol history being the only factor correlating with thiamine administration. Of known alcoholics and heavy drinkers, 56.1% and 26.2% respectively received thiamine as in-patients; 44.5% of patients received additional carbohydrate loads in the form of i.v. dextrose or parenteral nutrition, but only 28.9% of these received thiamine as well. Although the actual thiamine status of these patients was not known, given the difficulties of diagnosing WKS in the presence of a head injury, the conclusion is that written protocols are needed in units to ensure that head injury patients at risk of WKS receive appropriate thiamine treatment or prophylaxis.
Ferguson
R K
RK
Scottish Brain Injury Rehabilitation Service, Astley Ainslie Hospital, Grange Loan, Edinburgh, UK.
Soryal
I N
IN
Pentland
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006259:Craniocerebral Trauma / Q000150:complications* / Q000188:drug therapy; D016208:Databases, Factual; D005260:Female; D006801:Humans; D020915:Korsakoff Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012606:Scotland; D013831:Thiamine / Q000627:therapeutic use; D013832:Thiamine Deficiency / Q000150:complications / Q000188:drug therapy
D013831:Thiamine