알코올사용장애 환자에서 베르니케 뇌병증과 티아민 치료

Wernicke Encephalopathy and Thiamine Treatment for Patients with Alcohol Use Disorder

Wernicke’s encephalopathy is an acute and reversible neuropsychiatric disorder that can result from thiamine deficiency. It is most commonly associated with chronic alcohol misuse. Thiamine is a cofactor of three enzymes involved in two path-ways of carbohydrate metabolism associated with production of cells’ genetic material, neurotransmitters, glutathione or myelin sheath, and energy production. Thus, thiamine deficiency can lead to cell damage, particularly in the central nervous system. Clinical recommendations are provided for prophylactic or early treatment of suspected or diagnosed case of Wernicke’s encephalopathy. It is important to correct thiamine and magnesium deficiencies in order to recover neurologic symptoms or prevent further brain damage. The most effective regimen of thiamine treatment is parenteral treatment, especially intravenous infusion with higher dose and two or three daily doses instead of oral treatment.