RT Journal Article SR Electronic T1 Severe illicit gamma-hydroxybutyric acid withdrawal in a pregnant woman: what to do? JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e230997 DO 10.1136/bcr-2019-230997 VO 12 IS 12 A1 JC van Mechelen A1 BAG Dijkstra A1 ACM Vergouwen YR 2019 UL http://casereports.bmj.com/content/12/12/e230997.abstract AB This case report presents the case of a 29 weeks pregnant woman in her late twenties who was seen at the emergency department of a hospital with a seizure of unknown cause. By anamnesis and hetero-anamnesis the use of illicit gamma-hydroxybutyric acid (GHB) was revealed. Examination showed dilated pupils, sweating, tremor, tachycardia and bradyphrenic thinking. Subsequently, the seizure was indicated as a severe illicit GHB withdrawal symptom. Thereafter, treatment had to be decided on in the absence of evidence-based and practiced-based guidelines and treatment options for this specific patient population. Initially diazepam was started, which was later on substituted by sodium oxybate. Despite the critical professional situation the patient gave birth to a healthy daughter after 37 weeks of pregnancy.