Early diagnosis and treatment of Gaye ‒ Wernicke syndrome in a pregnant woman (a case from clinical practice)

Abstract

The issues of diagnosis, treatment and tactics of pregnancy management in patients with Gaye – Wernicke syndrome remain poorly illuminated and are represented by few observations. The article describes a clinical case of complication of gestosis in the first trimester of a pregnancy in the form of Gaye – Wernicke syndrome due to severe vomiting complicated by dehydration, pronounced electrolyte imbalance, protein, carbohydrate and fat metabolism in combination with comorbid pathology. The possibilities of early diagnosis and treatment of thiamine deficiency are considered. Gaye – Wernicke syndrome was diagnosed on the basis of clinical (combination of ophthalmoplegia, nystagmus, cerebellar ataxia and amentia) and laboratory and instrumental data. The vitamin B1 was administered according to the scheme: 200 mg 3 times a day intravenously for 7 days, then 100 mg 3 times a day intramuscularly for 7 days, then 100 mg orally 1 time a day for 7 days. Against the background of pathogenetic therapy, positive clinical and laboratory results were achieved within 20 days. Thus, when monitoring pregnant women with excessive vomiting, it is necessary to have high alertness regarding the development of disorders associated with thiamine deficiency. Timely and adequate replacement therapy prevents irreversible damage to the subcortical structures of the brain, disability, and possibly death in such patients, and also minimizes the risks of complications in the fetus.