A rare case of Wernicke's enceph-alopathy and dry beri-beri compli-cating hyperemesis gravidarum

• Published in: Brunei International Medical Journal
• Main Author: Ahmad Tarmizi N.A.; Abdullah A.; Abdul Hakim M.S.; Jaafar Laksama-na T.T.
• Format: Article
• Language: English
• Published: Ministry of Health 2017
• Online Access: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85029350333&partnerID=40&md5=d8cbc2b9da86e1ff70b3d2a64fac0392

Hyperemesis gravidarum occurs in approximately 0.3-2.0% of pregnancies. We present a rare case of Wernicke's encephalopathy and dry beriberi as a complication of hyperemesis gravidarum. A 23-year-old female, at 19 weeks gestation, presented with persistent vomiting since early pregnancy and feeling generally weak. Transabdominal ultrasound on presentation confirmed a non-viable foetus which was surgically removed. Throughout admission, she was noted to have confusion lasting a few days, horizontal nystagmus and progressive weakness with peripheral neuropathy of bilateral lower limbs. Her CT brain and lumbar puncture was normal. Nerve conduction studies was done, and coupled with her neurological findings, conclusion of thiamine deficiency was made. She was treated with thiamine and with rehabilitation she has currently made significant improvement. Thiamine deficiency manifesting with features suggestive of an overlap between Wernicke's encephalopathy and dry beriberi in patients with hyperemesis gravidarum is rare.