Wernicke's encephalopathy associated with fetal loss in a patient with severe hyperemesis gravidarum

ABSTRACT

Wernicke's encephalopathy is an acute neurological condition caused by thiamine deficiency. It is a rare disorder which classically occurs in alcoholic patients due to recurrent vomiting and poor oral intake. When it occurs in non-alcoholics, it is often missed and consequent mortality and morbidity is high. Pregnancy complicated by hyperemesis gravidarum represents one important clinical setting in which Wernicke's encephalopathy may occur. We present the case of a 32-year old lady who presented in the 18[th] week of her third pregnancy with recent history of difficulty walking, visual symptoms, poor concentration and lethargy. She had suffered with hyperemesis gravidarum for the preceding 10 weeks. Obstetric ultrasound revealed a dead fetus of 16 weeks size. The patient's neurological features improved significantly after starting parenteral thiamine