Wernicke's Encephalopathy Secondary to Hyperemesis Gravidarum in Pregnancy: A Case Report

Wernicke's Encephalopathy, although classically associated with chronic alcoholism, can also occur during pregnancy as a complication of hyperemesis gravidarum and is often underdiagnosed. We report a case of a 34-year-old pregnant woman at 16 weeks of gestation who presented with prolonged vomiting, altered mental status, nystagmus, and gait ataxia. Magnetic Resonance Imaging of the brain revealed characteristic bilateral thalamic and periaqueductal hyperintensities. Pregnancy increases thiamine requirements, and persistent vomiting in hyperemesis gravidarum can rapidly precipitate thiamine deficiency, leading to Wernicke's Encephalopathy; however, the classical triad is frequently incomplete, contributing to delayed diagnosis. Early recognition supported by imaging findings is crucial, as prompt administration of intravenous thiamine resulted in significant neurological recovery in our patient. This case highlights the importance of maintaining a high index of suspicion for Wernicke's Encephalopathy in pregnant women presenting with hyperemesis gravidarum and neurological symptoms, as timely parenteral thiamine therapy can lead to favorable maternal and fetal outcomes.