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Case Reports
. 2014 Mar;18(3):164-6.
doi: 10.4103/0972-5229.128706.

Wernicke's encephalopathy following hyperemesis gravidarum

Sandeep Kantor  1 , Sadanandan Prakash  1 , Juhi Chandwani  1 , Antara Gokhale  1 , Kalpana Sarma  1 , Maher J Albahrani  1
Affiliations
Case Reports

Wernicke's encephalopathy following hyperemesis gravidarum

Sandeep Kantor et al. Indian J Crit Care Med. 2014 Mar.

Abstract

Wernicke's encephalopathy (WE) is a potentially reversible yet serious neurological manifestation caused by vitamin B1(thiamine) deficiency. It is commonly associated with heavy alcohol consumption. Other clinical associations are with hyperemesis gravidarum (HG), starvation, and prolonged intravenous feeding. Most patients present with the triad of ocular signs, ataxia, and confusion. It can be associated with life-threatening complication like central pontine myelinolysis (CPM). We report two cases of WE following HG, with two different outcomes.

Keywords: Central pontine myelinolysis; Wernicke's encephalopathy; hyperemesis gravidarum.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Bilateral symmetrical increased signal intensity of the posteromedial aspect of both thalami on fluid attenuated inversion recovery images suggesting Wernicke's encephalopathy
Figure 2
Figure 2
Increased signal intensity of the periaqueductal gray matter in the midbrain and mammillary bodies, with no change in the signal intensity seen in the T1 weighted images suggestive of Wernicke's encephalopathy
Figure 3
Figure 3
Ill-defined areas of T2 increased signal intensity within the pons sparing the corticospinal tract with no evidence of diffusion restriction and hypointense signal on T1 weighted images and the picture suggestive of central pontine myelinolysis
Figure 4
Figure 4
Generalized widening of extra-axial cerebrospinal fluid spaces in both supra- and infratentrorial region with periaqueductal hyperintensity signal in long reptition times images and similar changes were also seen involving mammillary bodies, T2 hyperintense signal at medial aspect of both thalami with diffusion restriction suggestive of Wernicke's encephalopathy
See this image and copyright information in PMC

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