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Wernicke-Korsakoff Syndrome a Rare Complication of Hyperemesis Gravidarum: Case Report
Ayush Neupane1, Anil Shahi1, Bishaka Adhikari1
1Department of Internal Medicine Chitwan Medical College Bharatpur Nepal.
Hyperemesis gravidarum-induced Wernickes-Korsakoff syndrome (WKS) is an uncommon but potentially devastating disorder in pregnancy characterized by oculomotor abnormalities, cerebellar dysfunction, and either an altered mental state or mild memory impairment. However, most cases may not display the full spectrum of clinical abnormalities, we report a 34-year-old woman at 15 weeks of gestation who presented with all typical features of WKS, which includes worsening confusion, an unsteady gait, visual symptoms, and episodes of disorientation after two months of relentless vomiting. Clinical evaluation revealed dehydration, horizontal nystagmus, early papilledema, and biochemical evidence of malnutrition. MRI confirmed the diagnosis of WE. She responded to high-dose intravenous thiamine, electrolyte replacement, nutritional support, and ICU-level care. Neuropsychiatric symptoms, including impaired concentration, recent memory loss, and hallucinations, gradually resolved. She was discharged in stable condition after 26 days and demonstrated significant recovery with a normal fetal scan at follow-up. This case highlights the timely need for multidisciplinary treatment modalities and high-dose thiamine supplementation in pregnant women with severe hyperemesis to prevent irreversible neurological injury.
Hyperemesis gravidarum-induced Wernickes-Korsakoff syndrome (WKS) is an uncommon but potentially devastating disorder in pregnancy characterized by oculomotor abnormalities, cerebellar dysfunction, and either an altered mental state or mild memory impairment. However, most cases may not display the full spectrum of clinical abnormalities, we report a 34-year-old woman at 15 weeks of gestation who presented with all typical features of WKS, which includes worsening confusion, an unsteady gait, visual symptoms, and episodes of disorientation after two months of relentless vomiting. Clinical evaluation revealed dehydration, horizontal nystagmus, early papilledema, and biochemical evidence of malnutrition. MRI confirmed the diagnosis of WE. She responded to high-dose intravenous thiamine, electrolyte replacement, nutritional support, and ICU-level care. Neuropsychiatric symptoms, including impaired concentration, recent memory loss, and hallucinations, gradually resolved. She was discharged in stable condition after 26 days and demonstrated significant recovery with a normal fetal scan at follow-up. This case highlights the timely need for multidisciplinary treatment modalities and high-dose thiamine supplementation in pregnant women with severe hyperemesis to prevent irreversible neurological injury.
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