생물정신의학 (Korean Journal of Biological Psychiatry)

  • 제30권2호
  • /
  • Pages.84-88
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  • 2023
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  • 1225-8709(pISSN)
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  • 2005-7571(eISSN)
대한생물정신의학회 (The Korean Society of Biological Psychiatry)
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거리 노숙인 환자에게서 망상 증상과 함께 발견된 베르니케 뇌증 1례

Wernicke Encephalopathy in a Homeless Patient With Delusions: A Case Report

  • 김가영 (국립정신건강센터 정신사회재활과)
  • Kayoung Kim (Department of Social Psychiatry and Rehabilitation, National Center for Mental Health)
  • 투고 : 2023.06.26
  • 심사 : 2023.08.01
  • 발행 : 2023.10.31
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초록

Wernicke's encephalopathy is a life-threatening central nervous system disease caused by thiamine deficiency. Emergent diagnosis is crucial but is frequently underdiagnosed. If Wernicke's encephalopathy is concomitant with underlying psychiatric disorders, the progression of symptoms becomes less discernible. This can present challenges for clinicians in establishing definitive diagnoses. Frequent problematic drinking and chronic thiamine deficiency have been reported in the homeless population. Clinicians should consider the possibility of developing Wernicke's encephalopathy in this population. This case report describes a 43-years-old homeless patient with Wernicke's encephalopathy presented with psychiatric symptoms.

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과제정보

본 연구는 국립정신건강센터의 지원을 받았다. 사례를 담당하여 진료해주신 김다운 전공의와 MRI 판독소견에 도움을 주신 영상의학과 강경숙 선생님께 특별한 감사를 드립니다.

참고문헌

  1. Sinha S, Kataria A, Kolla BP, Thusius N, Loukianova LL. Wernicke encephalopathy-clinical pearls. Mayo Clin Proc 2019;94:1065-1072.  https://doi.org/10.1016/j.mayocp.2019.02.018
  2. Kim WJ, Kim MM. Wernicke's encephalopathy presenting with bilateral complete horizontal and downward gaze palsy in a malnourished patient. Korean J Ophthalmol 2017;31:372-374.  https://doi.org/10.3341/kjo.2017.0014
  3. Seo Y, Reed M, Chang JS, Lui F. Wernicke's encephalopathy presenting with confusion in a patient with schizophrenia. Cureus 2022;14:e32320. 
  4. Torvik A. Wernicke's encephalopathy--prevalence and clinical spectrum. Alcohol Alcohol Suppl 1991;1:381-384. 
  5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. Washington, DC: American Psychiatric Association Publishing;2022. 
  6. Harper CG, Giles M, Finlay-Jones R. Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy. J Neurol Neurosurg Psychiatry 1986;49:341-345.  https://doi.org/10.1136/jnnp.49.4.341
  7. Donnino MW, Vega J, Miller J, Walsh M. Myths and misconceptions of Wernicke's encephalopathy: what every emergency physician should know. Ann Emerg Med 2007;50:715-721.  https://doi.org/10.1016/j.annemergmed.2007.02.007
  8. Antunez E, Estruch R, Cardenal C, Nicolas JM, Fernandez-Sola J, Urbano-Marquez A. Usefulness of CT and MR imaging in the diagnosis of acute Wernicke's encephalopathy. AJR Am J Roentgenol 1998;171:1131-1137.  https://doi.org/10.2214/ajr.171.4.9763009
  9. Sullivan EV, Pfefferbaum A. Neuroimaging of the Wernicke-Korsakoff syndrome. Alcohol Alcohol 2009;44:155-165.  https://doi.org/10.1093/alcalc/agn103
  10. Kosis.kr [homepage on the Internet]. Daejeon: Statistics Korea [updated 2023 May 23; cited 2023 Jun 9]. Available from: https://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117098_2021A009&conn_path=I2. 
  11. Gilchrist G, Morrison DS. Prevalence of alcohol related brain damage among homeless hostel dwellers in Glasgow. Eur J Public Health 2005;15:587-588.  https://doi.org/10.1093/eurpub/cki036
  12. Ijaz S, Jackson J, Thorley H, Porter K, Fleming C, Richards A, et al. Nutritional deficiencies in homeless persons with problematic drinking: a systematic review. Int J Equity Health 2017;16:71. 
  13. Harrison RA, Vu T, Hunter AJ. Wernicke's encephalopathy in a patient with schizophrenia. J Gen Intern Med 2006;21:C8-C11.  https://doi.org/10.1111/j.1525-1497.2006.00600.x
  14. Oudman E, Wijnia JW, Oey MJ, van Dam MJ, Postma A. Wernicke encephalopathy in schizophrenia: a systematic review. Int J Psychiatry Clin Pract 2021;25:233-237. https://doi.org/10.1080/13651501.2020.1819333