Complete recovery in Wernicke's encephalopathy complicating hyperemesis gravidarum

BMJ Case Rep. 2019 Feb 7;12(2):e227530. doi: 10.1136/bcr-2018-227530.

Abstract

Wernicke's encephalopathy (WE) is an uncommon neurological complication in pregnancies complicated with hyperemesis due to thiamine deficiency. In women with hyperemesis, inadvertent glucose administration prior to thiamine supplementation triggers the development of neurological manifestations. Delay in the diagnosis can lead to maternal morbidity, and in one-third of cases may lead to persistence of some neurological deficit. With early recognition and thiamine supplementation, complete recovery is reported. We report a case of WE complicating a case of triplet pregnancy with hyperemesis gravidarum, which highlights the importance of early recognition and treatment, resulting in complete recovery as in the index case.

Keywords: obstetrics and gynaecology; pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Amikacin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Escherichia coli Infections / diagnosis*
  • Escherichia coli Infections / physiopathology
  • Escherichia coli Infections / therapy
  • Female
  • Fluid Therapy
  • Humans
  • Hyperemesis Gravidarum / complications*
  • Hyperemesis Gravidarum / physiopathology
  • Hyperemesis Gravidarum / therapy
  • Infant, Extremely Premature*
  • Infant, Premature, Diseases / mortality*
  • Pregnancy
  • Pregnancy, Triplet
  • Thiamine / therapeutic use*
  • Thiamine Deficiency / physiopathology
  • Thiamine Deficiency / therapy
  • Treatment Outcome
  • Wernicke Encephalopathy / diagnosis*
  • Wernicke Encephalopathy / drug therapy
  • Wernicke Encephalopathy / etiology
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Amikacin
  • Thiamine