Papilloedema delaying diagnosis of Wernicke's encephalopathy in a comatose patient

A case of acute Wernicke's encephalopathy due to hyperemesis gravidarum is described. Florid bilateral papilloedema was present, resulting in diagnostic uncertainty and delay in treatment. Attention is drawn to the rare occurrence of papilloedema in Wernicke's encephalopathy, and possible underlying mechanisms for this physical finding are considered.