Wernicke's syndrome associated with hyperemesis gravidarum

Afraa Brahim,Khaled Ben Jazia,Khalil Tarmiz,Mohamed Amine Bouslama

doi:10.5348/ijcri-201611-cs-10072

Abstract

Wernicke's syndrome associated with hyperemesis gravidarum

Highlights

Hyperemesis gravidarum during pregnancy can be complicated by Wernicke’s encephalopathy (WE)
Case Series: These are two cases of Wernicke’s encephalopathy complicating hyperemesis gravidarum occurred in two women during the first trimester of pregnancy
Diagnosis was confirmed by MRI scan, and the treatment consisted of intravenous thiamine and parenteral nutrition with a good maternal and fetal outcome

Summary

INTRODUCTION

Hyperemesis gravidarum is uncontrollable vomiting during pregnancy that can lead to serious complications like liver damage, esophageal rupture or Wernicke’s encephalopathy (WE), especially if it remains untreated. Wernicke’s encephalopathy is an acute neurological disorder related to poor thiamine absorption. It is a medical metabolic emergency which can lead to death if not managed aggressively. It was described by Carl Wernicke in 1881, in patients presenting with the triad of ocular signs, ataxia, and confusion [1]. A 28-year-old primigravida with no notable medical history was hospitalized in ICU at 14 weeks gestation for uncontrollable vomiting occurs six times per day during eight weeks before hospitalization. Cerebral MRI scan had been demanded because of neurological signs. It showed periventricular and periaqueductal hyper intensities in T2 sequence affirming WE syndrome. Symptoms may be vague and non-specific, i.e., headaches,

DISCUSSION

Findings

CONCLUSION