Intrauterine Fetal Demise: A Rare Complication of Wernicke's Encephalopathy Secondary to Hyperemesis Gravidarum

Abstract

Wernicke's encephalopathy (WE) is an acute neurological disorder caused by severe thiamine deficiency that manifests with a common range of clinical features including a triad of global confusion state, ophthalmoplegia, and ataxia. Though frequently associated with the alcohol-dependent population, WE has been seen in other patients where it often goes undiagnosed presumably due to rarity and variable clinical indications. In this case report, we highlight the importance of WE being considered as a differential diagnosis of acute encephalopathy particularly in women who have experienced fetal demise in conjunction with signs of malnourishment from hyperemesis gravidarum.

Keywords: intrauterine fetal demise; nausea and vomiting in pregnancy; nonalcoholic wernicke’s encephalopathy; vitamin b1 deficiency; wernicke encephalopathy.

Figure 1. Axial diffusion-weighted image showing an abnormal signal in bilateral dorsal thalami

Figure 2. Axial T2 FLAIR images showing an increased signal in the (A) bilateral dorsal thalami, (B) periaqueductal white matter and (C) bilateral mammillary bodies

FLAIR, fluid-attenuated inversion recovery