Ciwon Wernicke-Korsakoff

Cutar Wernicke-Korsakoff cuta ce ta kwakwalwa saboda ƙarancin bitamin B1 (thiamine).

Wernicke encephalopathy da Korsakoff ciwo yanayi ne daban daban waɗanda galibi ke faruwa tare. Dukansu suna faruwa ne saboda lalacewar kwakwalwa sakamakon rashin bitamin B1.

Rashin bitamin B1 ya zama ruwan dare ga mutanen da ke da rikicewar amfani da giya. Hakanan ya zama gama gari ga mutanen da jikinsu baya shan abinci yadda yakamata (malabsorption). Wannan na iya faruwa wasu lokuta tare da rashin lafiya mai tsanani ko bayan asara-nauyi (bariatric) tiyata.

Ciwon Korsakoff, ko Korsakoff psychosis, yakan zama kamar Wernicke encephalopathy yayin da alamun ke tafiya. Wernicke encephalopathy yana haifar da lalacewar kwakwalwa a ƙananan sassan kwakwalwa da ake kira thalamus da hypothalamus. Korsakoff psychosis yana haifar da lalacewa ta har abada ga ɓangarorin ƙwaƙwalwar da ke tattare da ƙwaƙwalwa.

Kwayar cututtukan Wernicke encephalopathy sun hada da:

• Rikicewa da asarar aikin hankali wanda zai iya ci gaba zuwa rashin lafiya da mutuwa
• Rashin haɗin tsoka (ataxia) wanda zai iya haifar da rawar kafa
• Gani yana canzawa kamar motsin ido mara kyau (motsawar gaba da gaba da ake kira nystagmus), hangen nesa biyu, faɗuwar fatar ido
• Janye barasa

Kwayar cututtuka na cutar Korsakoff:

• Rashin iya ƙirƙirar sababbin tunanin
• Rashin ƙwaƙwalwar ajiya, na iya zama mai tsanani
• Kirkirar labarai (confabulation)
• Gani ko jin abubuwan da basa wurin da gaske (mafarkai)

Binciken tsarin juyayi / jijiyoyin jiki na iya nuna lalacewa ga yawancin jijiyoyi:

• Motsawar ido mara kyau
• Rage ko abubuwan da ba daidai ba
• Saurin sauri (bugun zuciya)
• Pressureananan hawan jini
• Temperatureananan zafin jiki na jiki
• Rashin rauni na jiki da atrophy (asarar nama)
• Matsaloli tare da tafiya (tafiya) da daidaitawa

Mutumin na iya bayyana kamar ba shi da wadataccen abinci. Ana amfani da gwaje-gwaje masu zuwa don bincika matakin abincin mutum:

• Sinadarin albumin (yana da dangantaka da cikakken abincin mutum)
• Maganin bitamin B1
• Ayyukan transketolase a cikin jinin ja (rage cikin mutanen da ke fama da rashi na thiamine)

Harshen enzymes na iya zama babba a cikin mutanen da ke da tarihin cin zarafin barasa na dogon lokaci.

Sauran yanayin da zasu iya haifar da rashi bitamin B1 sun haɗa da:

• HIV / AIDs
• Cutar daji da suka bazu cikin jiki
• Matsanancin jiri da amai yayin ciki (hyperemesis gravidarum)
• Rashin zuciya (lokacin da aka bi da shi tare da maganin doretic na dogon lokaci)
• Dogon lokaci na maganin cikin jijiyoyin jini (IV) ba tare da karɓar ƙarin abubuwan ƙarancin abinci ba
• Yin wankin lokaci mai tsawo
• Matakan hormone masu girman gaske (thyrotoxicosis)

MRI na kwakwalwa na iya nuna canje-canje a cikin kwayar halitta ta kwakwalwa. Amma idan ana zargin cutar Wernicke-Korsakoff, ya kamata a fara magani nan da nan. Yawancin lokaci ba a buƙatar jarrabawar MRI ta kwakwalwa.

Makasudin magani shine don kula da alamun cuta da kuma hana cutar ta zama mai muni. Wasu mutane na iya buƙatar zama a asibiti da wuri a cikin yanayin don taimakawa sarrafa alamun.

Ana iya buƙatar saka idanu da kulawa ta musamman idan mutumin ya kasance:

• A cikin suma
• Rashin nutsuwa
• Rashin sani

Vitamin B1 yawanci ana bayar dashi ta hanyar allura a jijiya ko tsoka da wuri-wuri. Wannan na iya inganta bayyanar cututtuka na:

• Rikicewa ko hayyaci
• Matsaloli tare da hangen nesa da motsi ido
• Rashin daidaituwa tsakanin tsoka

Vitamin B1 sau da yawa baya inganta asarar ƙwaƙwalwar ajiya da hankali wanda ke faruwa tare da ƙwaƙwalwar Korsakoff.

Dakatar da amfani da giya na iya hana ƙarin asarar aikin ƙwaƙwalwa da lalata jijiyoyi. Ingantaccen daidaitaccen abinci mai gina jiki na iya taimakawa, amma ba maye gurbin dakatar da shan barasa ba.

Ba tare da magani ba, cutar Wernicke-Korsakoff tana ƙara ta'azzara koyaushe, kuma yana iya zama barazanar rai. Tare da jiyya, yana yiwuwa a iya sarrafa alamomin (kamar motsi mara haɗewa da wahalar gani). Hakanan za'a iya yin jinkirin ko dakatar da shi.

Matsalolin da zasu iya haifar sun hada da:

• Janye barasa
• Matsala tare da hulɗa ta sirri ko ta zamantakewa
• Raunin da faduwa ya haifar
• Neuropathy na giya na har abada
• Rashin asarar tunani na dindindin
• Rashin ƙwaƙwalwar ajiya na dindindin
• Guntun lokacin rayuwa

Kira mai ba da sabis na kiwon lafiya ko je dakin gaggawa idan kuna da alamun cutar Wernicke-Korsakoff, ko kuma idan an gano ku tare da yanayin kuma alamunku na daɗa muni ko dawowa.

Rashin shan giya ko shan giya daidai gwargwado da samun isasshen abinci mai gina jiki na rage haɗarin kamuwa da cutar Wernicke-Korsakoff. Idan mai shan giya mai yawa ba zai daina ba, abubuwan da ake amfani da su na tarin kwayoyin halitta da abinci mai kyau na iya rage damar samun wannan yanayin, amma ba a kawar da haɗarin ba.

Korsakoff psychosis; Ciwon shan barasa; Encephalopathy - giya; Cutar Wernicke; Yin amfani da barasa - Wernicke; Alcoholism - Wernicke; Aminearancin Thiamine - Wernicke

• Tsarin juyayi na tsakiya da tsarin juyayi na gefe
• Brain
• Tsarin kwakwalwa

Koppel BS. Abincin abinci mai gina jiki da cututtukan da ke tattare da barasa. A cikin: Goldman L, Schafer AI, eds. Magungunan Goldman-Cecil. 26th ed. Philadelphia, PA: Elsevier; 2020: babi na 388.

Don haka YT. Rashin cututtukan cututtuka na tsarin mai juyayi. A cikin: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology a cikin Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016: babi na 85.