r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2024-29-2-34-42r-n-j-552Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSЭнцефалопатия ВерникеWernicke encephalopathyhttps://orcid.org/0000-0001-6824-4114РамазановГ. Р.RamazanovG. R.

Москва

Moscow

ramazanovgr@sklif.mos.ruhttps://orcid.org/0000-0002-8490-1417КовалеваЭ. А.KovalevaE. A.

Москва

Moscow

kovalevaea@sklif.mos.ruhttps://orcid.org/0000-0003-3292-8789ПетриковС. С.PetrikovS. S.

Москва

Moscow

petrikovss@sklif.mos.ruhttps://orcid.org/0009-0008-1210-7370АйдиеваС. Б.AydievaS. B.

Москва

Moscow

saidaajdieva11@gmail.comhttps://orcid.org/0009-0005-8338-0647ВахромычевЮ. М.VakhromychevYu. M.

Москва

Moscow

van.gasvan@yandex.ruhttps://orcid.org/0009-0009-2718-8676ИотоваЯ. Ю.IotovaYa. Yu.

Москва

Moscow

iotova_yana@mail.ruhttps://orcid.org/0009-0008-2087-393XМахмудоваХ. Р.MakhmudovaKh. R.

Москва

Moscow

makhmudova.khayrat@mail.ruhttps://orcid.org/0009-0000-8687-6203НиколаеваА. Ю.NikolaevaA. Yu.

Москва

Moscow

nik.ann.ur@yandex.ruhttps://orcid.org/0000-0002-4177-5078ЯхьяеваС. А.YakhyaevaS. A.

Москва

Moscow

Sabiyat30@mail.ruНаучно-исследовательский институт скорой помощи им. Н.В. СклифосовскогоРоссияN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentRussian Federation2024240520242923442Copyright © Рамазанов Г.Р., Ковалева Э.А., Петриков С.С., Айдиева С.Б., Вахромычев Ю.М., Иотова Я.Ю., Махмудова Х.Р., Николаева А.Ю., Яхьяева С.А., 20242024Рамазанов Г.Р., Ковалева Э.А., Петриков С.С., Айдиева С.Б., Вахромычев Ю.М., Иотова Я.Ю., Махмудова Х.Р., Николаева А.Ю., Яхьяева С.А.Ramazanov G.R., Kovaleva E.A., Petrikov S.S., Aydieva S.B., Vakhromychev Y.M., Iotova Y.Y., Makhmudova K.R., Nikolaeva A.Y., Yakhyaeva S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/552Введение

Введение. Энцефалопатия Вернике (ЭВ) — жизнеугрожающее заболевание, вызванное дефицитом тиамина с развитием общемозговых и/или очаговых симптомов повреждения центральной нервной системы.

Цель исследования

Цель исследования: провести анализ этиологических факторов, клинической картины, лабораторных и инструментальных данных, а также клинических исходов ЭВ.

Материал и методы

Материал и методы. В исследование включены 36 пациентов, средний возраст составил 54,5 ± 15,9 года; женщин было 52,8%, мужчин — 47,2%.

Результаты

Результаты. Наиболее частыми причинами развития ЭВ были длительное злоупотребление алкоголем и заболевания желудочно-кишечного тракта или печени. Снижение уровня бодрствования выявлено у 63,9% пациентов в дебюте заболевания и у 72,2% — за все время госпитализации. У всех пациентов при МРТ головного мозга выявлены симметричные участки повышенного сигнала в режимах Т2 FLAIR и DWI в медиальных отделах обоих зрительных бугров, а в некоторых случаях также в области четверохолмной пластинки и/или периводопроводного пространства среднего мозга.

Заключение

Заключение. Оценка уровня тиамина крови не является обязательной перед стартом терапии, введение тиамина необходимо начинать без лабораторного подтверждения дефицита. Превентивное назначение тиамина в дозе 1000 мг в сутки оправдано при любом клиническом подозрении на энцефалопатию Вернике.

Introduction

Introduction: Wernicke’s encephalopathy is a life-threatening disease caused by thiamine deficiency with the development of damage to brain. Objective: to analyze the etiological factors, clinical, laboratory and instrumental data, as well as clinical outcomes of Wernicke’s encephalopathy.

Material and мethods

Material and мethods: the study included 36 patients with Wernicke’s encephalopathy. the average age of patients was 54.5 ± 15.9 years, women were 52.8%, men — 47.2%.

Results

Results: the most common causes of Wernicke’s encephalopathy were long-term alcohol abuse and diseases of the gastrointestinal tract or liver. A decrease in the level of wakefulness was detected in 63.9% of patients at the onset of the disease and in 72.2% during the entire period of hospitalization. In all patients, MRI of the brain revealed symmetrical areas of increased signal in the T2 FLAIR and DWI modes in the medial parts of both thalami, and in some cases also in the area of the quadrigeminal plate and/or periaqueductal space of the midbrain.

Conclusion

Conclusion. Assessment of blood thiamine levels is not mandatory before starting therapy; thiamine administration should be started without laboratory confirmation of deficiency. Preventive administration of thiamine at a dose of 1000 mg per day is justified for any clinical suspicion of Wernicke’s encephalopathy.

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The authors declare that there are no conflicts of interest present.