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Острая энцефалопатия была описана немецким психоневропатологом Карлом Вернике в 1881 году [1](https://ProBolezny.ru/encefalopatiya-vernike/). Одновременно с ним это состояние описал французский офтальмолог Шарль Гайе, поэтому заболевание ещё называют синдромом Гайе — Вернике [1](https://ProBolezny.ru/encefalopatiya-vernike/). \n\n**Распространённость**: среди людей в возрасте 30–70 лет энцефалопатия Вернике встречается примерно в 2% случаев [1](https://ProBolezny.ru/encefalopatiya-vernike/). В группу риска входят пожилые пациенты, бездомные и психические больные [1](https://ProBolezny.ru/encefalopatiya-vernike/).\n\n## Причины\nДефицит тиамина может быть вызван: \n* **Хроническим злоупотреблением алкоголем** — алкоголь препятствует кишечному всасыванию тиамина и его депонированию в печени [3](https://MedAboutMe.ru/zdorove/spravochnik/bolezni/sindrom_vernike_korsakova/)[6](https://yandex.ru/health/turbo/articles?id=328)[7](https://www.neuro-ural.ru/patient/dictonary/ru/ie/enczefalopatiya-gaje-vernike.html). \n* **Расстройствами питания** — плохое усвоение пищи, анорексия, булимия [7](https://www.neuro-ural.ru/patient/dictonary/ru/ie/enczefalopatiya-gaje-vernike.html). \n* **Нарушениями работы печени** (цирроз или гепатит) — эти состояния влияют на метаболизм многих витаминов, в том числе тиамина, и могут усугублять его дефицит [7](https://www.neuro-ural.ru/patient/dictonary/ru/ie/enczefalopatiya-gaje-vernike.html). \n* **Заболеваниями, влияющими на пищеварительную систему** (целиакия или синдром раздражённого кишечника) — могут приводить к недостаточному всасыванию биологически активных веществ [7](https://www.neuro-ural.ru/patient/dictonary/ru/ie/enczefalopatiya-gaje-vernike.html).\n\n## Симптомы\n**Характерно острое (в течение нескольких дней) развитие симптомов** [11](https://neva-clinic.ru/alkogolnaya-enczefalopatiya/): \n* **Глубокое помрачение сознания** — спутанность, дезориентация, возможны галлюцинации и бред [11](https://neva-clinic.ru/alkogolnaya-enczefalopatiya/). \n* **Неврологические расстройства** — атаксия (шаткость походки), тремор рук [11](https://neva-clinic.ru/alkogolnaya-enczefalopatiya/). \n* **Глазодвигательные нарушения** — нистагм (дрожание глазных яблок), двоение в глазах, частичный паралич глазодвигательных мышц [11](https://neva-clinic.ru/alkogolnaya-enczefalopatiya/). \n* **Вегетативные расстройства** — учащённый пульс, перепады артериального давления, резкая слабость, потливость [11](https://neva-clinic.ru/alkogolnaya-enczefalopatiya/). \n\n**Без срочного лечения** летальность при острой форме высока (до 20%) [11](https://neva-clinic.ru/alkogolnaya-enczefalopatiya/). При своевременной терапии острые проявления могут постепенно регрессировать [11](https://neva-clinic.ru/alkogolnaya-enczefalopatiya/).\n\n## Диагностика\n**Диагноз обычно устанавливается на основании клинической картины** [8](https://www.msdmanuals.com/ru/professional/%D1%81%D0%BF%D0%B5%D1%86%D0%B8%D0%B0%D0%BB%D1%8C%D0%BD%D1%8B%D0%B5-%D1%82%D0%B5%D0%BC%D1%8B/%D0%B7%D0%B0%D0%BF%D1%80%D0%B5%D1%89%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5-%D0%B8-%D0%BE%D0%B4%D1%83%D1%80%D0%BC%D0%B0%D0%BD%D0%B8%D0%B2%D0%B0%D1%8E%D1%89%D0%B8%D0%B5-%D0%B2%D0%B5%D1%89%D0%B5%D1%81%D1%82%D0%B2%D0%B0/%D1%8D%D0%BD%D1%86%D0%B5%D1%84%D0%B0%D0%BB%D0%BE%D0%BF%D0%B0%D1%82%D0%B8%D1%8F-%D0%B2%D0%B5%D1%80%D0%BD%D0%B8%D0%BA%D0%B5). Специфические диагностические обследования отсутствуют [8](https://www.msdmanuals.com/ru/professional/%D1%81%D0%BF%D0%B5%D1%86%D0%B8%D0%B0%D0%BB%D1%8C%D0%BD%D1%8B%D0%B5-%D1%82%D0%B5%D0%BC%D1%8B/%D0%B7%D0%B0%D0%BF%D1%80%D0%B5%D1%89%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5-%D0%B8-%D0%BE%D0%B4%D1%83%D1%80%D0%BC%D0%B0%D0%BD%D0%B8%D0%B2%D0%B0%D1%8E%D1%89%D0%B8%D0%B5-%D0%B2%D0%B5%D1%89%D0%B5%D1%81%D1%82%D0%B2%D0%B0/%D1%8D%D0%BD%D1%86%D0%B5%D1%84%D0%B0%D0%BB%D0%BE%D0%BF%D0%B0%D1%82%D0%B8%D1%8F-%D0%B2%D0%B5%D1%80%D0%BD%D0%B8%D0%BA%D0%B5). Однако могут проводить лабораторные анализы, чтобы исключить другую этиологию [8](https://www.msdmanuals.com/ru/professional/%D1%81%D0%BF%D0%B5%D1%86%D0%B8%D0%B0%D0%BB%D1%8C%D0%BD%D1%8B%D0%B5-%D1%82%D0%B5%D0%BC%D1%8B/%D0%B7%D0%B0%D0%BF%D1%80%D0%B5%D1%89%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5-%D0%B8-%D0%BE%D0%B4%D1%83%D1%80%D0%BC%D0%B0%D0%BD%D0%B8%D0%B2%D0%B0%D1%8E%D1%89%D0%B8%D0%B5-%D0%B2%D0%B5%D1%89%D0%B5%D1%81%D1%82%D0%B2%D0%B0/%D1%8D%D0%BD%D1%86%D0%B5%D1%84%D0%B0%D0%BB%D0%BE%D0%BF%D0%B0%D1%82%D0%B8%D1%8F-%D0%B2%D0%B5%D1%80%D0%BD%D0%B8%D0%BA%D0%B5).\n\n## Лечение\n**Основной метод** — **массивная витаминная терапия**, прежде всего тиамин (витамин B1) внутривенно в высоких дозах [11](https://neva-clinic.ru/alkogolnaya-enczefalopatiya/). Также вводят комплекс других витаминов группы B (B6, B12, фолиевая кислота) и витамин С для поддержки нервной системы [11](https://neva-clinic.ru/alkogolnaya-enczefalopatiya/). \n\n**Проводится интенсивная инфузионная терапия** для устранения метаболических нарушений, препараты для улучшения мозгового кровообращения и питания нейронов (ноотропы, нейропротекторы) [11](https://neva-clinic.ru/alkogolnaya-enczefalopatiya/). \n\n**Важнейшее условие лечения** — полный отказ от алкоголя, необходимо лечить основное заболевание — алкоголизм [11](https://neva-clinic.ru/alkogolnaya-enczefalopatiya/).","linksData":[{"sourceId":1,"url":"https://ProBolezny.ru/encefalopatiya-vernike/","shownUrl":"https://ProBolezny.ru/encefalopatiya-vernike/","title":"Энцефалопатия Вернике: причины, симптомы и лечение в статье невролога Абдусаламова С. 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