Abstract
Wernicke encephalopathy (WE) is an acute neurological disorder resulting from vitamin B1 deficiency, which is common in chronic alcoholism. We report a rare case of WE due to hyperemesis gravidarum in a 25-year-old pregnant patient at 13 weeks and 5 days of gestation. Initially, the disease manifested as weakness, mental confusion, anterograde amnesia, and visual and auditory hallucinations. The diagnosis was established after the detection of suggestive findings of WE in the thalamus by magnetic resonance imaging (MRI) and a rapid improvement in the patient's clinical status subsequent to treatment with thiamine. Hyperemesis is a rare cause of WE, which makes the reported case important in the literature and reinforces the need for attention in clinical practice to rare but important complications of this common condition (hyperemesis gravidarum).
Highlights
Nausea and vomiting are very common during pregnancy (NVP), affecting up to 80% of pregnancies.[1,2,3] Hyperemesis gravidarum (HG), which can be described as severe NVP, affects up to 3% of all pregnancies and frequently leads to weight loss, dehydration, and electrolyte imbalance.[2,4] Hyperemesis gravidarum is the most common indication for hospitalization in the first half of pregnancy.[4]
We report a rare case of Wernicke encephalopathy (WE) due to hyperemesis gravidarum in a 25-year-old pregnant patient at 13 weeks and 5 days of gestation
The laboratory tests reinforced the finding of malnutrition, and the magnetic resonance imaging (MRI) showed alterations in the thalamus region
Summary
Nausea and vomiting are very common during pregnancy (NVP), affecting up to 80% of pregnancies.[1,2,3] Hyperemesis gravidarum (HG), which can be described as severe NVP, affects up to 3% of all pregnancies and frequently leads to weight loss, dehydration, and electrolyte imbalance.[2,4] Hyperemesis gravidarum is the most common indication for hospitalization in the first half of pregnancy.[4]. A 25-year-old pregnant patient at 13 weeks and 5 days of gestational age, in her third pregnancy, presented to our emergency department with symptoms of weakness, mental confusion, anterograde amnesia, and visual and auditory hallucinations. One month before this first visit, the patient reports having presented hypoxia and vomiting. The patient evolved with improved thyroid function, and presented normal exams in 2 months. She was diagnosed with gestational diabetes mellitus but obtained good control with diet. The newborn is being followed-up with genetics and neurology, with a probable diagnosis of DandyWalker malformation (DWM)
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