我院3年来收治Wernicke-korsakoff综合征2例,现举1例报告并分析如下。 患者男,38岁。入院前1个月走路不稳,呈醉酒样,经常撞人和摔倒,四肢远端麻木、无力,时有视物成双。4天前因与邻居争吵,空腹喝白酒1斤半后昏睡约24小时,醒来后言语不清,四肢抖动,不能站立及行走,并诉说看到满屋小鸟在飞,与人交谈时词不达意,表情呆滞,反应迟钝,说话夸张。有饮酒史20年,平时每日喝0.5～1斤白酒。 入院体检:血压18/12kPa,心、肺、腹无明显异常。神经系统检查:表情淡漠,反应迟钝,答非所问,记忆力、计算力均有障碍,舌、四肢均有不自主粗大震颤。眼底正常,左眼外展及内收受限,右眼外展受限,双眼球水平震颤。指鼻、轮替及跟膝胫试验不准,四肢肌张力稍低,肌力V°,四肢远端是手套、袜套样感觉减退,四肢腱反射(+)。病理反射及脑膜刺激征(-)。实验室、颅脑CT检未见异常。 治疗中绝对戒酒,给予大量维生素B族(主要是维生素B_1)及三磷酸腺苷、辅酶A、复方氨基酸及脑活素治疗,并加用奋乃静控制精神症状,复视半个月后消失,精神症状明显好转,能正确回答问题,60天后能自己行走,但行走时两腿分得很宽, 2 cases of Wernicke-korsakoff syndrome admitted to our hospital for 3 years, 1 case report and analysis are as follows. Male patient, 38 years old. 1 month before admission, walking instability, was drunk, often hit and fell, limb numbness, weakness, sometimes double as the material. 4 days ago due to quarrel with his neighbors, fasting drink about 1 kg of half an hour after sleeping drowsiness for about 24 hours, woken up unconscious, limbs shaking, can not stand and walk, and complained about seeing the house bird flying, talking to people Words are not satisfactory, dull expression, unresponsive, exaggerated words. A history of drinking 20 years, usually daily drink 0.5 to 1 kg of liquor. Admission examination: blood pressure 18 / 12kPa, heart, lung, abdomen no obvious abnormalities. Nervous system examination: apathetic, unresponsive, non-questioning, memory, computational power are obstacles, tongue, limbs have involuntary tremor. Fundus normal, left eye abduction and adduction limited right eye abduction limited, both eyes tremor level. Refers to the nose, the rotation and the trial of knee shin are not allowed. The limb muscle tension is slightly lower, muscle strength V °. The distal limbs are gloves, socks and trocar-like sensory loss, tendon reflexes (+). Pathological reflex and meningeal irritation (-). Laboratory, CT examination showed no abnormal brain. Absolute abstinence during treatment, given a large number of vitamin B group (mainly vitamin B_1) and adenosine triphosphate, coenzyme A, compound amino acids and cerebrolysin therapy, and add perphenazine to control mental symptoms, diplopia disappeared after half a month, the spirit Obvious improvement in symptoms, can correctly answer the question, 60 days after walking, but when walking legs wide,