Neuropsychiatric presentation of Wernicke’s Encephalopathy occurs to a pregnant Woman: A case report

Introduction Wernicke’s encephalopathy (WE) is a severe neuropsychiatric syndrome resulting from thiamine deficiency (vit B1) wich often associated with chronic alcoholism. The classical presentation characterized by ophtalmoplegia, ataxia and confusion. Unfortunately, WE still underdiagnosed because it may not always show up in one hand, could also be seen other non alcoholic condition an hand which delay diagnosis managment of early proper treatement Objectives This case highlights the importance considering atypical presentations encephalopathy, it’s medical etiologies improving to manage Methods We reported pregnant women who consulted for alterated mental status , asthenia occurs have due hyperemesis gravidarum Results Mrs X 35-year-old past history cesarian, hospitalisation third month this pregnancy vomits, no known psychiatric illness or substance abuse. She was brought gynecology emergency department altered status. MRS X, lethargic, had eaten several days, vomiting more than month. On evaluation she appeared confused, disoriented, unresponsive verbal manual redirection prompting. gait incoordination. Laboratory testing remarkable lactic acidosis (blood lactate concentration lipasemia normal electrolyte levels, cerebrospinal fluid (CSF) culture unremarkable. A brain MRI done showed FLAIR signal abnormalities around ventricle periaqueductal, suggesting Gayet-Wernicke encephalopathy. Thiamine 500mg thrice day administrated next days associtation vitamin B6. Conclusions Wernicke acute reaction usually presents triad. However, Clinicians tend ignore non-alcoholic clinical settings becomes even difficult when unusual signs symptoms like catatonia. WE, necessity complete appropriate investigations make prompt management. Disclosure Interest None Declared