title: Beyond alcoholism: Wernicke-Korsakoff syndrome in patients with psychiatric disorders.
abstract: OBJECTIVE
  Wernicke encephalopathy and Korsakoff syndrome (the combined disorder is named Wernicke-Korsakoff syndrome [WKS]) are preventable, life-threatening neuropsychiatric syndromes resulting from thiamine deficiency. WKS has historically been associated with alcoholism; more recently, it has been recognized in patients who have anorexia nervosa or have undergone bariatric surgery for obesity. However, patients with nutritional deficiencies of any origin are at risk for WKS. We present clinical histories and neuroimaging data on 2 young adults with underlying psychiatric disorders who became malnourished and developed WKS.
  
  
  METHODS
  A young woman with bipolar disorder and somatization disorder was hospitalized for intractable vomiting. A young man with chronic paranoid schizophrenia developed delusions that food and water were harmful, and was hospitalized after subsisting for 4 months on soda pop.
  
  
  RESULTS
  Acute, life-threatening Wernicke encephalopathy was confirmed in both patients by brain magnetic resonance imaging showing classic thalamic injury. The patients were left with persistent cognitive and physical disabilities that were consistent with Korsakoff syndrome.
  
  
  CONCLUSIONS
  Failure to suspect a vitamin deficiency led to permanent cognitive and physical disabilities that may necessitate lifelong care for these patients. The neuropsychiatric consequences could have been prevented by prompt recognition of their thiamine deficiency.
authors: Department of Psychiatry, Psychiatric Iowa Neuroimaging Consortium, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. laurie-mccormick@uiowa.edu
authors: Laurie M
authors: LM
authors: McCormick
authors: Judith R
authors: JR
authors: Buchanan
authors: Obiora E
authors: OE
authors: Onwuameze
authors: Ronald K
authors: RK
authors: Pierson
authors: Sergio
authors: S
authors: Paradiso
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000523:psychology*; D001714:Bipolar Disorder / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D020915:Korsakoff Syndrome / Q000150:complications / Q000473:pathology / Q000523:psychology*; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000523:psychology; D008297:Male; D012563:Schizophrenia, Paranoid / Q000150:complications / Q000523:psychology*; D013001:Somatoform Disorders / Q000150:complications / Q000523:psychology*; D013788:Thalamus / Q000473:pathology; D013832:Thiamine Deficiency / Q000150:complications / Q000523:psychology*