Recurrent Wernicke’s encephalopathy in pregnancy

A case report

Angela Stephens, Khilen Patel, Ashwin Rao, Paul Browne, Susanna Raley, Linda Street

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Wernicke’s encephalopathy (WE) is an acute neurologic syndrome resulting from a deficiency in thiamine, also known as Vitamin B1. Thiamine stores can be depleted rapidly in patients with severe hyperemesis. Treatment with thiamine typically results in complete resolution of the neurological abnormalities. Case report: A 15-year-old G2P0010 at 13.2 weeks gestation presented with altered mental status and transaminitis. She had a medical termination in her previous pregnancy following an admission for a similar clinical scenario. She was initially thought to have a postoperative surgical complication due to recent cholecystectomy, but further evaluation revealed thiamine depletion. Magnetic resonance imaging confirmed the diagnosis of WE. Repletion of thiamine and folic acid resulted in rapid clinical improvement. Conclusion: WE should be considered in the differential diagnosis of pregnant patients with hyperemesis and altered mental status. A prior history of WE increases the risk of recurrence during pregnancy. Severe hyperemesis during pregnancy increases the risk of thiamine deficiency and WE. Early thiamine supplementation may reduce the risk of WE in patients with a prior clinical history or in patients with severe hyperemesis gravidarum.

Original languageEnglish (US)
Pages (from-to)528-530
Number of pages3
JournalNutritional Neuroscience
Volume22
Issue number7
DOIs
StatePublished - Jul 3 2019

Fingerprint

Wernicke Encephalopathy
Thiamine
Pregnancy
Thiamine Deficiency
Hyperemesis Gravidarum
Cholecystectomy
Folic Acid
Nervous System
Differential Diagnosis
Magnetic Resonance Imaging
Recurrence

Keywords

  • Hyperemesis gravidarum
  • Pregnancy
  • Thiamine
  • Wernicke’s encephalopathy

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Neuroscience(all)
  • Nutrition and Dietetics

Cite this

Stephens, A., Patel, K., Rao, A., Browne, P., Raley, S., & Street, L. (2019). Recurrent Wernicke’s encephalopathy in pregnancy: A case report. Nutritional Neuroscience, 22(7), 528-530. https://doi.org/10.1080/1028415X.2017.1416941

Recurrent Wernicke’s encephalopathy in pregnancy : A case report. / Stephens, Angela; Patel, Khilen; Rao, Ashwin; Browne, Paul; Raley, Susanna; Street, Linda.

In: Nutritional Neuroscience, Vol. 22, No. 7, 03.07.2019, p. 528-530.

Research output: Contribution to journalArticle

Stephens, A, Patel, K, Rao, A, Browne, P, Raley, S & Street, L 2019, 'Recurrent Wernicke’s encephalopathy in pregnancy: A case report', Nutritional Neuroscience, vol. 22, no. 7, pp. 528-530. https://doi.org/10.1080/1028415X.2017.1416941
Stephens, Angela ; Patel, Khilen ; Rao, Ashwin ; Browne, Paul ; Raley, Susanna ; Street, Linda. / Recurrent Wernicke’s encephalopathy in pregnancy : A case report. In: Nutritional Neuroscience. 2019 ; Vol. 22, No. 7. pp. 528-530.
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