Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 15 , ISSUE 5 ( September-October, 2023 ) > List of Articles


Wernicke's Encephalopathy: A Rare Complication of Hyperemesis Gravidarum

Krutika Vivek Bhalerao, Sandhya Pajai

Keywords : Ataxia, Case report, Hyperemesis gravidarum, Mental confusion, Thiamine, Wernicke's encephalopathy

Citation Information : Bhalerao KV, Pajai S. Wernicke's Encephalopathy: A Rare Complication of Hyperemesis Gravidarum. J South Asian Feder Obs Gynae 2023; 15 (5):607-609.

DOI: 10.5005/jp-journals-10006-2095

License: CC BY-NC 4.0

Published Online: 31-10-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: A case of Wernicke's encephalopathy (WE) due to hyperemesis gravidarum is presented for its rarity and favorable outcome of pregnancy due to timely diagnosis and management. Background: Wernicke's encephalopathy is a rare reversible neurological complication of hyperemesis gravidarum due to vitamin B1 (thiamine) deficiency. Hyperemesis gravidarum (HG) is associated with prolonged starvation and electrolyte imbalance leading to Wernicke's encephalopathy, which is a triad of ocular signs, ataxia, and confused mental state. It also leads to a serious complications like central pontine myelinolysis (CPM). During pregnancy, Wernicke's encephalopathy has poor outcomes in mother and baby. A fifth gravida presented at 14 weeks of gestation with Wernicke's encephalopathy was treated with thiamine, recovered after 34 days, and delivered by cesarean section at 36.5 weeks, a live healthy baby. Conclusion: A favorable outcome of pregnancy can be there with a high index of suspicion, timely diagnosis, and management with thiamine. Clinical significance: Immediate supplementation of thiamine in antenatal women with prolonged vomiting in pregnancy, especially before starting intravenous glucose can prevent this reversible neurological condition.

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  1. Cirignotta F, Manconi M, Mondini S, et al. Wernicke–Korsakoff encephalopathy and polyneuropathy after gastroplasty for morbid obesity: report of a case. Arch Neurol 2000;57(9):1356–1359. DOI: 10.1001/archneur.57.9.1356.
  2. Netravathi M, Sinha S, Taly AB, et al. Hyperemesis-gravidarum-induced Wernicke's encephalopathy: serial clinical, electrophysiological and MR imaging observations. J Neurol Sci 2009;284(1–2):214–216. DOI: 10.1016/j.jns.2009.05.004.
  3. Harper C. The incidence of Wernicke's encephalopathy in Australia: a neuropathological study of 131 cases. J Neurol Neurosurg Psychiatry 1983;46(7):593–598. DOI: 10.1136/jnnp.46.7.593.
  4. Sulaiman W, Othman A, Mohamad M, et al. Wernicke's encephalopathy associated with hyperemesis gravidarum – a case report. Malays J Med Sci 2002;9(2):43–46. PMCID: PMC3406206.
  5. Kantor S, Prakash S, Chandwani J, et al. Wernicke's encephalopathy following hyperemesis gravidarum. Indian J Crit Care Med 2014:18(3);164–166. DOI: 10.4103/0972-5229.128706.
  6. Michel ME, Alanio E, Bois E, et al. Wernicke's encephalopathy complicating hyperemesis gravidarum: a case report. Eur J Obstet Gynecol Reprod Biol 2010;149:118–119. PMID: 19913987.
  7. Caine D, Halliday GM, Kril JJ, et al. Operational criteria for the classification of chronic alcoholics: identification of Wernicke's encephalopathy. J Neurol Neurosurg Psychiatry 1997;62(1):51–60. DOI: 10.1136/jnnp.62.1.51.
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