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Wernicke's encephalopathy induced by hyperemesis gravidarum
G Gárdián1, E Vörös, T Járdánházy
1Department of Neurology, Albert Szent-Györgyi Medical University, Szeged, Hungary.
Acta Neurologica Scandinavica
|April 1, 1999
Summary
Hyperemesis gravidarum can cause Wernicke's encephalopathy, a serious neurological condition. Prompt treatment with thiamine (vitamin B1) is crucial for maternal and fetal outcomes.
Area of Science:
- Neurology
- Obstetrics & Gynecology
Background:
- Hyperemesis gravidarum (HG) is characterized by severe nausea and vomiting during pregnancy.
- Wernicke's encephalopathy (WE) is a neurological emergency caused by thiamine deficiency.
Observation:
- A 25-year-old pregnant patient with HG developed classic WE symptoms, including altered sensation, nystagmus, and ataxia.
- Brain MRI confirmed WE, showing bilateral thalamic, hypothalamic, and periaqueductal gray matter lesions.
Findings:
- Intramuscular and oral thiamine (vitamin B1) treatment led to an uncomplicated pregnancy and delivery of a healthy infant.
- Literature review identified 20 additional WE cases secondary to HG in the last 30 years.
- Only 50% of pregnancies complicated by HG-induced WE resulted in a normal infant.
Implications:
- Early recognition and aggressive thiamine supplementation are vital for managing WE in pregnant patients.
- This case highlights the importance of considering WE in pregnant individuals with severe vomiting and neurological signs.
- Optimal management strategies for HG-induced WE require further investigation to improve fetal survival rates.