Sun Yat-Sen University China
Title: Diagnoses and treatments of chronic alcoholic toxic cerebral encephalopathy: an expert consensus Specialized Committee Professional Board of Brain and Spinal Cord Injury, Neurology Branch of Chinese Medical Doctor Association
Ying Peng, M.D. & Ph.D. From 1997 to 2001, he got his post-doctor training in National Institutes of Health, USA. Now He is working in Sun Yaat-Sen Memorial Hospital, Sun Yat-Sen University as a full-professor. His current research fields include: 1. Addiction & Toxic Encephalopathy; 2. Gene therapy of Neurological Disease; 3. Cerebral ischemic stroke; 4.Brain injure and neural regeneration. He got 7 funds during the period of working in the University of Hong Kong and 16 grants after working in the Sun Yat-Sen Memorial Hospital. He published 105 papers in SCI journals. Additionally, he got the “Fellows Award for Research Excellence 2001”, sponsored by National Institutes of Health of USA., and the “Second Prize for Scientific Technique Progress Award of Guangdong Province” in China.
Chronic alcoholism encephalopathy is a common disease existing all over the world, which is an important symptom of alcohol abuse and alcoholism. In order to promote neurologists’ understanding, popularize the standardized diagnosis and treatment of chronic alcoholism encephalopathy, we have made extensive discussion to reach the following consensus on the principles related to the clinical diagnosis and treatment on chronic alcoholism encephalopathy.I. Definition of chronic alcoholic encephalopathy : Chronic alcoholism encephalopathy is a chronic and recrudescent brain disease caused by alcohol acting on the brain tissue due to long-term drinking, that is to say, a seriously poisoning condition on the central nervous system caused by excessive drinking for a long time, and almost all patients have dependently chronic pathogenesis of alcohol syndrome. II. Clinical manifestations and characteristics of chronically alcoholic encephalopathy : We divide chronic alcoholism encephalopathy into 6 kinds of syndrome according to the patient's clinical manifestation and the condition of onset and the duration of the disease, including Wernicke encephalopathy, Coxsackoff syndrome, chronic alcoholism dementia, alcoholic tremor-delirium, alcoholic epilepsy, alcoholically mental and behavioral disorders.III. Clinical diagnosis of chronic alcoholic encephalopathy : The coring symptoms/diagnostic criteria for alcohol dependence are described in DSM-4/ICD-10 as followings (3 Or more of the following within 12 months): (1)Alcoholic tolerance;(2)interrupting symptoms/reactions after stopping drinking; (3)Excessive intake; (4)Beyond control and abstinence; (5)Spending a lot of time seeking, acquiring and ingesting alcohol; (6)The intention of social communication is decreased; (7)Regardless of any adverse consequences. The clinicians should be based on the above-mentioned diagnostic criteria, combined with the clinical manifestations and imaging characteristicsfor comprehensive judgment. IV. Treatment of chronically alcoholic encephalopathy : Abstinence from alcohol: Currently first-line medicine: Nalmefen, naloxone, dithiolam, aconic acid; The second-line medicine: Baclofen, topiramate, benzodiazepines, tricyclic antidepressants, high-dose antioxidants. Others include etiological treatment, correction on nutritional disorders, brain-protecting therapy, rehabilitation therapy and others.