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Neglected woman with hyperemesis gravidarum leading to Wernicke encephalopathy
  1. Papa Dasari and
  2. Smitha Priyadarshini
  1. Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
  1. Correspondence to Professor Papa Dasari; dasaripapa{at}gmail.com

Abstract

A teenage primigravida at 13 weeks of gestation presented with hyperemesis gravidarum of 45 days and a history of giddiness and inability to walk due to involuntary movements of limbs and eyes since 2 days. She was treated with intravenous fluids, thiamine and antiemetics. MRI brain showed hyperintensities in bilateral dorsomedial thalami, periaqueductal grey matter in T2-weighted and FLAIR images. A diagnosis of Wernicke encephalopathy was made and she was managed in intensive care unit and received injection thiamine as per the guidelines and her weakness and ataxia improved over 3 weeks and she was discharged at 17 weeks of pregnancy in good state of health.

  • materno-fetal medicine
  • neuroimaging
  • obstetrics
  • gynaecology and fertility

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Footnotes

  • Contributors PD has managed the case and written the manuscript and SP has collected the images and contributed to literature review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.