Wernicke's Encephalopathy Complicating Hyperemesis during Pregnancy
نویسندگان
چکیده
Wernicke's encephalopathy is caused by severe thiamine deficiency; it is mostly observed in alcoholic patients. We report the case of a 28-year-old woman, at 17 weeks of gestational age, with severe hyperemesis gravidarum. She presented with disturbance of consciousness, nystagmus, ophthalmoplegia, and ataxia. The resonance magnetic imagery showed bilaterally symmetrical hyperintensities of thalamus and periaqueductal area. The case was managed with very large doses of thiamine. The diagnosis of Wernicke's encephalopathy was confirmed later by a low thiamine serum level. The patient was discharged home on day 46 with mild ataxia and persistent nystagmus. Wernicke's encephalopathy is a rare complication of hyperemesis gravidarum. It should be diagnosed as early as possible to prevent long-term neurological sequela or death. Thiamine supplementation in pregnant women with prolonged vomiting should be initiated, especially before parenteral dextrose infusion. Early thiamine replacement will reduce maternal morbidity and fetal loss rate.
منابع مشابه
Hyperemesis gravidarum complicated by Wernicke's encephalopathy.
BACKGROUND Wernicke's encephalopathy is usually associated with alcohol abuse, but can also occur with hyperemesis gravidarum. The effect of delay in thiamine replacement on fetal outcomes is unknown. We present a case of this complication. CASE A primipara with hyperemesis was admitted for mental status changes in her 14th week of pregnancy. Physical examination revealed a lethargic patient ...
متن کاملWernicke's encephalopathy with visual loss in a patient with hyperemesis gravidarum.
OBJECTIVE We describe a case of Wernicke's encephalopathy associated with visual loss that was caused by hyperemesis gravidarum. METHODS A 25 year old lady in her 20th week of her pregnancy consulted us. She had history of nausea and vomiting for 3 months with resultant weight loss. She now presented with sub-acute onset of visual loss in both her eyes, and gait disturbance with unsteadiness....
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A 20-year-old woman developed severe persistent vomiting early in pregnancy. In three months she lost 18 kg of body weight: and showed the biochemical features of mild hepatic failure. Four days after starting intravenous dextrose and insulin, she developed short-term miemory loss, confusion, ataxia, dysarthria, mild left upper motor neurone facial weakness and upbeat nystagmus. Thiamine was gi...
متن کاملOcular manifestations in a case of Wernicke's encephalopathy due to hyperemesis gravidarum
Wernicke's Encephalopathy (WE) is a potentially devastating disorder, which if not diagnosed and treated at the earliest, could lead to dangerous neurological and ophthalmological complications. We report the ocular manifestations of WE in a pregnant woman with hyperemesis gravidarum.
متن کاملWernicke's Encephalopthy Associated with Hyperemesis Gravidarum - A Case Report.
Two cases of Wernicke's encephalopathy due to hyperemesis gravidarum are described. The first patient presented with bilateral papilloedema, altered sensorium and the second with bilateral retinal haemorrhages, ophthalmoplegia and nystagmus. Both patients were diagnosed with Wernicke's encephalopathy on clinical ground since there were no laboratory facilities to measure red cell transketolase ...
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ورودعنوان ژورنال:
دوره 2016 شماره
صفحات -
تاریخ انتشار 2016