Background: A 17-year-old pregnant woman presented to hospital at 19 weeks' gestation with an 8-week history of hyperemesis gravidarum, 16.8 kg of weight loss, and new-onset weakness, dizziness and blurred vision. Examination of the patient showed confusion, papilledema, ophthalmoparesis, nystagmus, reduced hearing and truncal ataxia. Investigations: Physical examination, abdominal ultrasound, fetal ultrasound, brain MRI, magnetic resonance angiography, magnetic resonance venography and cerebrospinal-fluid analysis. Diagnosis: Wernicke's encephalopathy, hyperemesis gravidarum and fetal loss. Management: Intravenous thiamine repletion and elimination of deficiency risk factors.
- Hyperemesis gravidarum
- MRI paraventricular hyperintensities
- Thiamine deficiency
- Wernick's encephalopathy
ASJC Scopus subject areas
- Clinical Neurology
- Cellular and Molecular Neuroscience