Nukae nye Wernicke-Korsakoff Dɔléle? Mina míaƒo nu tso eŋu!

Èse nɔnɔme wɔnuku aɖe si gblẽa nu le ahɔhɔ̃a kple ŋkuɖoɖonudzi ŋu kpɔa? Ɣeaɖewoɣi la, míenya gɔ̃ hã be ne vitamin aɖewo mele míaƒe ŋutilã me o, vevietɔ vitamin B1 si woyɔna be ``Thiamine`` la, míaƒe ahɔhɔ̃ ateŋu agblẽ vevie. Nɔnɔme sesẽ mawo dometɔ ɖekae nye Wernicke-Korsakoff Dɔléle (WKS) . Esia nye nɔnɔme si hiã be woawɔ atike na ame kpata ŋutɔŋutɔ. Ðe míaƒo nu tso esia ŋu bɔbɔe, le mɔ si gɔme nàse nua?

Nuka tututue nye Wernicke-Korsakoff ƒe dɔléle (`WKS`)?

Kpuie ko la, esia nye dɔléle si gblẽa nu le míaƒe ahɔhɔ̃ kple ŋkuɖoɖonudzi ŋu. Susu vevitɔ si tae nye be míaƒe ŋutilã me ‘Thiamine’ (`Thiamine`) alo vitamin B1 dzi ɖe kpɔtɔ ŋutɔ. Bu eŋu kpɔ, míaƒe ŋutilã le abe ʋu ene. Ʋu sia ƒe mɔ̃e nye ahɔhɔ̃. Mɔ̃a hiã mɔ̃memi hafi wòate ŋu awɔ dɔ. Nenema ke vitamin si woyɔna be 'Thiamine` (`Thiamine`) le vevie na míaƒe ahɔhɔ̃ kple lãmekawo ƒe dɔwɔwɔ. Vitamin siae trɔa nuɖuɖu si míeɖuna wòzua ŋusẽ. Eyata ne woɖe ‘Thiamine` (`Thiamine`) sia dzi kpɔtɔ la, ahɔhɔ̃a mekpɔa ŋusẽ si wòhiã o, eye emegbe ahɔhɔ̃a ƒe lãmenugbagbeviwo dzea gbegblẽ gɔme.

Akpa vevi eve le `WKS` sia me:

1. Wernicke ƒe tagbɔdɔ: Esiae nye ahɔhɔ̃a ƒe abi gbãtɔ, kpata, si nu sẽ ŋutɔ. Ebia be woawɔ atike nɛ enumake.

2. Korsakoff ƒe dɔléle: Esia nye dɔléle si nɔa anyi didi si gblẽa nu le ŋkuɖoɖonudzi ŋu vevie.

Wotsɔ Germanytɔ ahɔhɔ̃ŋutinunyala Carl Wernicke kple Russiatɔ ahɔhɔ̃ŋutinunyala Sergei Korsakoff, amesiwo de dzesi dɔlélea zi gbãtɔ la ƒe ŋkɔ nɛ.

Ƒomedodo kae le ‘Wernicke ƒe tagbɔdɔléle’ kple ‘Korsakoff ƒe dɔléle’ dome?

Wo ame evea do ƒome kple wo nɔewo. Ne míagblɔe tututu la, nɔnɔme aɖe si woyɔna be ``Wernicke encephalopathy``, ne womewɔ atike nɛ le ɣeyiɣi nyuitɔ dzi o la, enye nusi va zua ŋkuɖoɖonudzi ƒe kuxi sesẽ aɖe si woyɔna be ``Korsakoff syndrome`` vivivi.

Zi geɖe la, dzesi vevi etɔ̃e dzena le Wernicke ƒe tagbɔdɔléle ŋu:

• Tɔtɔ: Ame ƒe susu ƒe bu, teƒe kple ɣeyiɣi ƒe bu.
• Dadasɔ ƒe bu kple ŋutetemanɔamesi be woaɖu ʋuʋu dzi (`Ataxia`): Azɔlizɔzɔ meganɔa te o eye abɔwo kple afɔwo dzi ɖuɖu va sesẽna.
• Nukpɔkpɔ ƒe tɔtrɔ kple ŋku ƒe kuxiwo: Ŋku ƒe ʋuʋu si mesɔ o, abe nukpɔkpɔ zi gbɔ zi eve ene.

Tsɔ kpe ɖe esia ŋu la, ɣeaɖewoɣi la, lãmekawo gɔ̃ hã te ŋu gbɔdzɔna.

Ne dzesi siawo nɔa anyi ɣeyiɣi didi la, nu gblẽna le ahɔhɔ̃a kple lãmekawo ŋu tegbee. Esiae nye ɣeyiɣi si me ŋkuɖoɖonudzi bu vevie eye womate ŋu aɖo ŋku ŋkuɖodzinya yeyewo dzi o. Woyɔa esia be ``Korsakoff ƒe dɔléle``.

Wernicke-Korsakoff Syndrome (WKS) nye dɔléle si ate ŋu agblẽ ɖe edzi vivivi le ɣeyiɣi aɖe megbe eye ate ŋu ade ame ƒe agbe afɔku me gɔ̃ hã. Eyata atikewɔwɔ kpata kple thiamine le vevie ŋutɔ. Esia wɔwɔ ate ŋu akpe ɖe ame ŋu wòaɖe dzesiawo dzi akpɔtɔ eye wòaxe mɔ ɖe ŋkuɖoɖonudzi kple ahɔhɔ̃a ƒe dɔwɔwɔ bubuwo ƒe gbegblẽ tegbee.

Ne dzesi siawo le wò alo ame aɖe si te ɖe ŋuwò ŋu la, ele be nàyi ɖɔkta enumake alo ayi kɔdzi si te ɖe ŋuwò.

Ameka dzie nɔnɔme sia gblẽ nu le wu?

Wernicke-Korsakoff ƒe dɔléle (WKS) bɔ ɖe ŋutsuwo me wu nyɔnuwo. Zi geɖe la, edzɔna ɖe ame siwo xɔ tso ƒe 30 va ɖo ƒe 70. Ame akpa gãtɔ siwo xɔa WKS le ahanono ta la nye ŋutsu siwo xɔ wu ƒe 40. Gake nyɔnuwo kple sɔhɛwo hã ate ŋu axɔ dɔlélea le susu bubu siwo menye ahanono o ta. Ƒã hafi wogblɔnɛ le ɖevi suewo ŋu.

Amekawoe le afɔku gã me be woaxɔ Wernicke-Korsakoff ƒe dɔlélea?

Wernicke tagbɔdɔ nye dɔléle si wokpɔna wu le amesiwo noa aha fũu akpa (ahanono ƒe kuxi). Ne wono aha ɣeyiɣi didi la, egblẽa nu le dɔgboa kple nuɖuɖumeŋusẽ ŋu. Edoa kplamatse ŋutilã ƒe ŋutete be wòaxɔ vitaminwo hã (malabsorption). Wogblɔ be ahatsunola siwo ade 80% mate ŋu axɔ thiamine si sɔ alo alée ɖe te o.

Gakpe ɖe eŋu la, ame siwo mate ŋu axɔ nuɖuɖu nyuie o le atikewɔwɔ ƒe nɔnɔme aɖewo ta hã ate ŋu axɔ `WKS`. Le kpɔɖeŋu me, ateŋu adzɔ le lolo dzi ɖeɖe kpɔtɔ ƒe dɔwɔwɔ vɔ megbe (`bariatric surgery`) alo abe `chemotherapy` ƒe nugbegblẽ le kansa ŋu ene.

Afɔku bubu aɖewoe nye esi:

• Dɔgbo me dɔlélewo, le kpɔɖeŋu me, dɔgbo ƒe dɔléle alo dɔgbo ƒe dɔléle.
• Kansa (vevietɔ le dɔléle sesẽwo me).
• Lãmetsiŋusẽ ƒe agbɔsɔsɔ si sɔ gbɔ akpa le lãkusi me (thyrotoxicosis).
• Domenyiŋusẽfianu ƒe tɔtrɔ aɖewo.
• Aɖuɖɔtoedɔdamɔnu zazã na dzidɔ ɣeyiɣi didi.
• Thiamine ƒe anyimanɔmanɔ ƒe dɔlélewo abe HIV/AIDS ene.
• Ayiku ƒe dɔmawɔmawɔ nyuie, elabena ayiku ƒe atikewɔwɔ ɣeyiɣi didi ɖea ŋutilã ƒe ŋutete be wòaxɔ thiamine dzi kpɔtɔna.
• Atikewɔƒewo alo nuɖuɖu siwo me nunyiame le ƒe anyimanɔmanɔ.
• Aɖuɖɔtoe kple ʋuʋudedi fũ le fufɔɣi (hyperemesis gravidarum).

Nukawoe hea ‘Wernicke-Korsakoff ƒe dɔléle’ vɛ?

Susu vevitɔ si tae nye ``Thiamine`` ƒe anyimanɔmanɔ. Vitamin vevi siae trɔa sukli si míeɖuna wòzua ŋusẽ. Eyata ne ``Thiamine`` mele mía si o la, míaƒe ahɔhɔ̃ mekpɔa ŋusẽ si hiã be wòawɔ dɔ nyuie o.

Nu vevitɔ si gbɔ thiamine ƒe anyimanɔmanɔ tsonae nyeAhanono fũu akpa le ɣeyiɣi didi aɖe me. Ahanono nana wòsesẽna na ŋutilãa be wòaxɔ thiamine eye wòadzrae ɖo ɖe aklã me. Aha sesẽ hã doa kplamatse vitamin B1 zazã hena dɔ vevi bubuwo wɔwɔ.

Susu bubuwo hã li:

• Nuɖuɖu si mesɔ o: Nuɖuɖu si da sɔ ɖuɖu o.
• Nuɖuɖukuxiwo: abe nuɖuɖumadzroame kple nuɖuɖumadzroame ene.
• Dɔlékui siwo nɔa anyi didi.
• Amekoko: Vevietɔ amekoko abe dɔgbo ƒe dɔwɔwɔ na ame hena lolo dzi ɖeɖe kpɔtɔ ene.
• Ahɔhɔ̃ ƒe abi si nu sẽ: Gake esia mebɔ vie o.

Nukae nye ‘Wernicke-Korsakoff ƒe dɔléle’ ƒe dzesiwo?

Esia ate ŋu adze le dzesi vovovowo me. Dzesi siwo wokpɔna zi geɖe le dɔléle sesẽwo me dometɔ ɖekae nye ‘aʋatsokaka’ . Eyae nye ŋutinyawo wɔwɔ le susu me be nàtsɔ atsyɔ nu nusiwo dzi mèɖo ŋkui o dzi. Bu eŋu kpɔ, ame aɖe meɖo ŋku nane si wòwɔ etsɔ dzi o, gake egblɔa alakpa be yeatsɔ atsyɔ nu edzi, gake womeda alakpa o elabena wosusu be edzɔ ŋutɔŋutɔ. Woxɔ ŋutinyaa dzi se.

Zi geɖe la, amesiwo ŋu dɔléle sia le ate ŋu atɔtɔ alo woƒe susu atɔtɔ. Tɔtɔ sia na wòsesẽna na wo be woakpɔe adze sii be nane gblẽ le yewo ŋu eye woadi atike.

Wernicke ƒe tagbɔdɔléle ƒe dzesi siwo bɔ :

• Dadasɔ ƒe bu alo ŋutetemanɔamesi be wòaɖu ʋuʋu dzi (ataxia).
• 'Nyakpakpawo gbɔgblɔ'.
• Tɔtɔ, tagbɔdɔléle.
• Azɔlizɔzɔ sesẽ, azɔlizɔzɔ si meli ke o.
• Alɔ̃dɔdɔ.
• Ŋutilã ƒe dzoxɔxɔ si bɔbɔ le mɔ si mesɔ o nu (hypothermia).
• Dzi ƒe kuxiwo: dzi ƒe tsotso ƒe dzidziɖedzi (tachycardia) alo ʋu ƒe sisi (hypotension).
• Lãmetsiwo ƒe dɔwɔwɔ ɖekae ƒe bu (ataxia).

Ŋku ƒe kuxiwo hã bɔ:

• Ŋku ƒe ʋuʋu si mesɔ o (nystagmus).
• Nukpɔkpɔ eve.
• Ŋku ƒe akpa si le etame ƒe ɖiɖi (ptosis).
• Ŋku ƒe lãmekawo ƒe dɔmawɔmawɔ nyuie alo gbɔdzɔgbɔdzɔ (ŋku ƒe dɔmawɔmawɔ nyuie).

Ne womewɔ atike na Wernicke ƒe tagbɔdɔ o la, ate ŋu ava zu Korsakoff ƒe dɔléle, si nye ŋkuɖoɖonudzi ƒe dɔléle si nɔa anyi didi. Eƒe dzesiwo dometɔ aɖewoe nye:

• Ŋkuɖoɖonudzi ƒe bu keŋkeŋ (`Amnesia`) alo ŋutetemanɔamesi be woaɖo ŋku nu yeye aɖeke dzi.
• Nuwɔna ƒe tɔtrɔ: dzikudodo, dzikudodo kabakaba.
• 'Nyakpakpawo gbɔgblɔ'.
• Delirium kple susu ƒe dɔmawɔmawɔ nyuie.
• Ðeɖiteameŋu alo kuviawɔwɔ.
• Susukpɔkpɔ, vevietɔ ne woɖe asi le ahanono ŋu.
• Ŋutete be yeƒe susu nanɔ nu ŋu.
• Azɔlizɔzɔ si meli ke o.

Dzesi aɖewo meva nyona ɖe edzi keŋkeŋ ne wowɔ atike na wo gɔ̃ hã o. Le nɔnɔme sesẽwo me la, ame ƒe susu ƒe dɔwɔwɔ (`coma`) ateŋu adzɔ. Ne wò alo ame aɖe si te ɖe ŋuwò ƒe susu megale dɔ wɔm o, alo ne `Wernicke-Korsakoff syndrome` ƒe dzesiwo le ŋuwò la, yi ɖɔkta alo yi xɔ si me wowɔa dɔ kpata le enumake.

Aleke wokpɔa ‘Wernicke-Korsakoff ƒe dɔlélea’?

`WKS` nɔnɔme sia kpɔkpɔ kaba le vevie ŋutɔ na atikewɔwɔ dzidzedzetɔe. Ðɔktawo dea dzesii to ŋutilãmedɔdada, wò dzesiwo biabia, kple wò ƒome ŋutinya biabia me. Gake ate ŋu asesẽ be woanya dɔlélea ne ame aɖe tɔtɔ alo eƒe ŋku megaɖoa ŋku nu dzi o.

Ðɔktaa alé ŋku ɖe nu siawo ŋu koŋ:

• Ðe ahanono ƒe kuxi aɖewo li (`Ahanono ƒe kuxi`)?
• Ðe nunyuimakpɔɖu aɖe lia?
• Ðe thiamine ƒe anyimanɔmanɔ aɖe lia?

Dodokpɔ kawoe kpena ɖe ame ŋu wòkpɔa Wernicke-Korsakoff ƒe dɔlélea?

Wò ɖɔkta aɖe gbe be woado wò ʋu kpɔ atsɔ akpɔ sukli kple thiamine ƒe agbɔsɔsɔ le wò ʋu me. Woate ŋu aɖe gbe hã be woado ahanono kpɔ le ʋu me atsɔ akpɔe ɖa be ahanono hã eye woado aklã ƒe dɔwɔwɔ kpɔ be aklãa le dɔ wɔm hã, elabena esia ate ŋu afia be aklãa gblẽ.

Woate ŋu awɔ dodokpɔ bubuwo atsɔ akpɔe ɖa be nu bubu siwo gbɔ wòtso hã:

• Ʋuka me gas (ABG) dodokpɔ, si léa ŋku ɖe ya si woyɔna be carbon dioxide kple oxygen ƒe agbɔsɔsɔ si le ʋua me ŋu.
• 'Ʋu xexlẽ blibo' (`Ʋu xexlẽ blibo - CBC`).
• Aɖiŋutinunya ƒe dodokpɔ.

Ðewohĩ ahiã hã be nàwɔ nɔnɔmetatawo dodokpɔ abe esiawo ene:

• 'CT-dɔdamɔnu'.
• 'MRI' (`MRI`) ƒe agbalẽ.
• 'Elektrodzitodzito' (`Elektrodzitodzito - EKG`).

Ðe woate ŋu ada Wernicke-Korsakoff Dɔlélea? Aleke wowɔa atike nɛ?

Le nyateƒe me la, womate ŋu adae keŋkeŋ o. Gake ne wodze atikewɔwɔ gɔme kaba la, woate ŋu aɖe dzesiawo dzi akpɔtɔ eye woate ŋu atrɔ wo dometɔ aɖewo. Esia fia be woateŋu atɔ te nɔnɔme si nye ``Wernicke encephalopathy`` be wòagagblẽ ɖe edzi va ɖo ``Korsakoff syndrome``.

Zi geɖe la, atikewɔwɔ ate ŋu aɖu dzesiwo abe tɔtɔ, ŋku ƒe kuxiwo, kple dadasɔ ƒe anyimanɔmanɔ dzi alo ana woanyo ɖe edzi. Wò ɖɔkta awɔ atikewɔwɔ ƒe ɖoɖo si asɔ na wò.

Zi geɖe la, wowɔa nusiwo gbɔna abe atikewɔwɔ ene:

• Vitamin B1 nana to atikekuiwo alo atikekuiwo dodo me.
• Ne tsi vɔ le ŋutilãa me la, na saline to ``IV fluids`` dzi.
• Kuxi siwo do ƒome kple ahanono dada.
• Nunyiame ƒe kpekpeɖeŋu nana.
• Na atike bubuwo ne ehiã.

Aleke nàwɔ aɖe dɔléle sia xɔxɔ ƒe afɔkua dzi akpɔtɔ?

Zi geɖe la, ahanono dzi ɖeɖe kpɔtɔ alo edzi ɖeɖe kpɔtɔe nye nu vevitɔ kekeake si nàte ŋu awɔ be nàɖe Wernicke-Korsakoff ƒe dɔlélea xɔxɔ ƒe afɔkua dzi akpɔtɔ. Azɔ hã, nunyiame nyui xɔxɔ kple ne ehiã la, thiamine kpeɖeŋutɔ nono le atikekui alo atikekuiwo ƒe nɔnɔme me ate ŋu akpe ɖe ŋuwò nàɖe wò afɔkua dzi akpɔtɔ, vevietɔ na amesiwo ahatsunono zu numame na.

Nukae nye nyagblɔɖi na amesi ŋu Wernicke-Korsakoff ƒe dɔlélea le?

Ne dɔléle sia le wò alo ame aɖe si te ɖe ŋuwò ŋu la, alesi dzesiawo nu sẽe kple alesi wokpɔa dɔlélea kaba hedaa dɔe dzi. Atikewɔwɔ kaba ate ŋu atrɔ dzesiawo eye wòaxe mɔ ɖe kuxi siwo anɔ anyi ɣeyiɣi didi nu. Gake ne womewɔ atike nɛ o la, ate ŋu ana ame nazu nuwɔametɔ eye wòaku gɔ̃ hã.

Ɣekaɣie wòle be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo le nɔnɔme sia ŋu?

Ne Wernicke-Korsakoff ƒe dɔlélea ƒe dzesiwo le wò alo ame aɖe si nènya ŋu la, yi atikewɔƒe enumake. Ðewohĩ ahiã be nàƒo ka na wò ɖɔkta alo ayi kɔdzi ƒe xɔ si me wowɔa dɔ kpata le si te ɖe ŋuwò me hena atikewɔwɔ kpata.

Aleke malé be na ɖokuinye?

Wernicke-Korsakoff ƒe dɔléle ƒe dzesi xɔxɔ menye dɔ bɔbɔe o. Ðewohĩ ahiã be woaxɔ wò ɖe kɔdzi eye woawɔ atike na wò. Nu vevitɔe nye be nàwɔ ɖe wò ɖɔkta ƒe aɖaŋuɖoɖowo dzi, abe ahanono dzi ɖeɖe kpɔtɔ (alo edzi ɖeɖe kpɔtɔ keŋkeŋ) kple nuɖuɖu si me nunyiame le ɖuɖu ene. Nu siawo akpe ɖe ŋuwò ŋutɔ be nàhaya.

Wɔ ɖe wò ɖɔkta ƒe mɔfiamewo dzi nyuie be nàkpɔ kuxiwo gbɔ ahada dzesiawo. Awɔ belélename ƒe ɖoɖo si sɔ na wò eye wòakpe ɖe ŋuwò nàgaɖo wò lãmesẽ me.

Wernicke-Korsakoff ƒe dɔlélea nye ŋkuɖoɖonudzi ƒe dɔléle si mebɔ o gake wòsẽ ŋutɔ. Ebia be woawɔ atike na wo kpata be woaɖe dzesiawo dzi akpɔtɔ eye woaxe mɔ ɖe kuxiwo nu. Ne dɔlélea le sesẽm ɖe edzi la, lãmekawo ƒe dzesiwo, abe tɔtɔ vevie kple susu ƒe tɔtɔ ene, dzena. Dzesi siawo ate ŋu ana wòasesẽ na wò alo ame aɖe si te ɖe ŋuwò be nàde dzesi wò nɔnɔmea. Eyata ele vevie be woanya dɔlélea kaba. Wò ɖɔkta aɖo aɖaŋu na wò be nàwɔ atikewɔmɔnu si sɔ ɖe wò nuhiahiãwo nu.

Nu vevitɔ kekeake siwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Enyo, eyata nu vevi siwo dzi wòle be míaɖo ŋkui le `Wernicke-Korsakoff Syndrome` si ŋu míeƒo nu tsoe ŋue nye esi:

• Esia nye nɔnɔme sesẽ aɖe si gblẽa nu le ahɔhɔ̃a kple ŋkuɖoɖonudzi ŋu le thiamine (vitamin B1) ƒe anyimanɔmanɔ ta.
• Nusi koŋ ate ŋu ahe afɔku vɛ enye ahanono fũu akpa.
• Afɔɖeɖe gbãtɔe nye Wernicke tagbɔdɔ, si ne womedae o la, ate ŋu ahe ŋkuɖoɖonudzi ƒe kuxi aɖe si nɔa anyi didi si woyɔna be Korsakoff ƒe dɔléle vɛ.
• Tɔtɔ, azɔlizɔzɔ sesẽ, nukpɔkpɔ ƒe kuxiwo, kple ŋkuɖoɖonudzi ƒe dɔmawɔmawɔ nyuie ate ŋu anye dzesi vevitɔwo.
• Dɔlélea didi kabakaba kple thiamine zazã kpata le vevie ŋutɔ.
• Togbɔ be womate ŋu adae keŋkeŋ o hã la, atikewɔwɔ kaba ate ŋu aɖu dzesiawo dzi eye wòaxe mɔ ɖe nusiwo agblẽ nu le eŋu tegbee nu.
• Ne wò alo ame aɖe si nènya le dzesi siawo ɖem fia la, di atikewɔlawo ƒe aɖaŋuɖoɖo enumake.

Mele mɔ kpɔm be nyatakaka sia aɖe vi na wò. Nɔ lãmesẽ me!

` Wernicke-Korsakoff ƒe dɔléle, thiamine ƒe anyimanɔmanɔ, vitamin B1, ahanono, ŋkuɖoɖonudzi ƒe dɔmawɔmawɔ nyuie, ahɔhɔ̃mekawo ƒe dɔmawɔmawɔ nyuie, ahɔhɔ̃medɔlélewo