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Recurrent Wernicke's encephalopathy in pregnancy: A case report
Angela Stephens1, Khilen Patel1, Ashwin Rao2
1a Department of Obstetrics and Gynecology , Augusta University , Augusta , GA , USA.
Nutritional Neuroscience
|December 23, 2017
Summary
Wernicke
Area of Science:
- Neurology
- Obstetrics & Gynecology
- Nutritional Science
Background:
- Wernicke's encephalopathy (WE) is an acute neurological condition caused by thiamine (Vitamin B1) deficiency.
- Severe hyperemesis during pregnancy can rapidly deplete thiamine stores, increasing WE risk.
- Prompt thiamine treatment usually resolves neurological symptoms.
Observation:
- A 15-year-old pregnant patient presented with altered mental status and elevated liver enzymes.
- Initial assessment suggested a surgical complication, but thiamine depletion was identified.
- MRI confirmed Wernicke's encephalopathy; thiamine and folic acid repletion led to recovery.
Findings:
- The case highlights a pregnant patient with severe hyperemesis and altered mental status diagnosed with WE.
- Thiamine deficiency was the underlying cause, confirmed by imaging and clinical response.
- The patient had a history of a similar episode requiring medical termination.
Implications:
- Wernicke's encephalopathy should be considered in pregnant patients with hyperemesis and altered mental status.
- A history of WE increases recurrence risk during subsequent pregnancies.
- Early thiamine supplementation is crucial for pregnant patients with severe hyperemesis or a history of WE.
