Wernicke encephalopathy의 원인

1881 년, Carl Wernicke는  mental confusion, ophthalmoplegia, gait ataxia가 특징인 급성 뇌증을 기술했으며, 이것을 제 3 뇌실, 제 4 뇌실 및 aqueduct 주위의 punctate hemorrhages에 대한 부검 소견과 관련시켰습니다. 몇 년 후, 러시아 정신과 의사 Sergei Korsakoff는 기억이 다른 인지 영역에 비해 크게 손상된 chronic amnestic syndrome을 기술했습니다. 만성 알코올 중독의 맥락에서 두 가지 관찰이 모두 기술되었지만, Wernicke와 Korsakoff는 처음에는 두 질환 사이의 관계를 인식하지 않았으며, 나중에 다른 연구자들에 의해 평가되었습니다.

대부분 만성 알코올 중독과 관련이 있지만 ㉠malabsorption, ㉡poor dietary intake, ㉢increased metabolic requirement(예, during systemic illnesses), ㉣increased loss of the water-soluble vitamin thiamine에 의한 poor nutrition 상황에서 발생할 수 있습니다.  WE와 관련된 조건은 다음과 같습니다.

Chronic alcoholism
Anorexia nervosa or dieting
Hyperemesis of pregnancy
Prolonged intravenous feeding without proper supplementation 
Prolonged fasting or starvation, or unbalanced nutrition, especially with refeeding
Gastrointestinal surgery (especially bariatric surgery)
Systemic malignancy
Transplantation
Hemodialysis or peritoneal dialysis 
Acquired immunodeficiency syndrome 


REF. UpToDate 2018.08.01