Wernicke's encephalopathy induced by hyperemesis gravidarum

A report is presented on a patient with Wernicke's encephalopathy secondary to hyperemesis gravidarum. The 25-year-old female presented 11 weeks into pregnancy with prolonged vomiting. Neurological examination 8 weeks later d emonstrated obtunded sensations, nystagmus and ataxia of gait. MR imaging r evealed bilateral lesions in the mediodorsal nuclei of thalami, in the hypo thalamus and in the periaqueductal gray matter (1). The neurological signs and the MRI findings pointed to a diagnosis of Wernicke's encephalopathy. T he patient was treated with intramuscular vitamin B-1 followed by oral thia mine until the end of pregnancy. The subsequent course of the pregnancy was uncomplicated, and resulted in the delivery of a healthy 2970 g male infan t. A review of the literature published during the last 30 years revealed a n additional 20 cases of Wernicke's encephalopathy induced by hyperemesis g ravidarum. Only half of these pregnancies resulted in the birth of a normal infant.