The Older Brain on Drugs: Substances That May Cause Cognitive Impairment

Jenny Rogers, MD; Bonnie S. Wiese, MD; Kiran Rabheru, MD, CCFP, FRCP

Disclosures

Geriatrics and Aging. 2008;11(5):284-289. 

In This Article

Wernicke-Korsakoff Syndrome

Clinically, the term Wernicke-Korsakoff syndrome is best conceptualized as two distinct syndromes, one associated with the confusional state and often reversible findings of Wernicke encephalopathy, the other the persistent and irreversible learning and memory deficits of Korsakoff dementia. The term Wernicke encephalopathy is used to describe the clinical triad of confusion, ataxia, and nystagmus.[17,18] Thiamine deficiency resulting from moderate to heavy alcohol use through subsequent malnutrition and malabsorption damages regions of the hypothalamus, diencephalon, and brain stem.[16] This damage is reversible with thiamine replacement therapy early in the course of illness but becomes irreversible over time.[19] There is a range of susceptibility to thiamine deficiency and subsequent risk of brain damage among heavy alcohol users that may be partly related to abnormalities in the transketolase protein found in susceptible individuals.[20]

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