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Wernicke's encephalopathy: beyond alcoholism
Robin K Wilson1, Ralph W Kuncl, Andrea M Corse
1Department of Neurology, Johns Hopkins University, Baltimore, MD 21287-7519, USA.
Background:
A 17-year-old pregnant woman presented to hospital at 19 weeks' gestation with an 8-week history of hyperemesis gravidarum, 16.8 kg of weight loss, and new-onset weakness, dizziness and blurred vision. Examination of the patient showed confusion, papilledema, ophthalmoparesis, nystagmus, reduced hearing and truncal ataxia.
Investigations:
Physical examination, abdominal ultrasound, fetal ultrasound, brain MRI, magnetic resonance angiography, magnetic resonance venography and cerebrospinal-fluid analysis.
Diagnosis:
Wernicke's encephalopathy, hyperemesis gravidarum and fetal loss.
Management:
Intravenous thiamine repletion and elimination of deficiency risk factors.
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