Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Case Report
  • Published:

Wernicke encephalopathy—a rare complication of hyperemesis gravidarum

European Journal of Clinical Nutrition volume 74, pages 663–665 (2020)Cite this article

Subjects

Abstract

We report a rare case of Wernicke encephalopathy (WE) in a 35-year-old woman with hyperemesis gravidarum (HG). Initially, the disease manifested as passivity, a loss of interest, sleeping too much, apathy and disorientation. The correct diagnosis was established after the detection of typical pathological findings of WE in the thalamus by magnetic resonance imaging (MRI), which was indicated for the appearance of eye symptomatology in the form of nystagmus. Subsequent treatment with thiamine led to rapid improvement in the patient’s clinical status and a favorable course of pregnancy.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Magnetic resonance imaging of the brain and axial fluid-attenuated inversion recovery (FLAIR) sequences.

Similar content being viewed by others

References

  1. Fattal-Valevsky A. Thiamine (Vitamin B1). J Evid Based Complemet Altern Med. 2011;16:12–20.

  2. Sechi G, Serra A. Wernicke’s encephalopathy: new clinical settings and recent advances in diagnosis and management. Lancet Neurol. 2007;6:442–55.

    Article  CAS  Google Scholar 

  3. Ropper AH, Samuels MA, Klein JP, Prasad S. Adams and Victor’s principles of neurology. 11th ed. New York: McGraw-Hill Education; 2019.

  4. Galvin R, Brathen G, Ivashynka A, Hillbom M, Tanasescu R, Leone MA. EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. Eur J Neurol. 2010;17:1408–18.

    Article  CAS  Google Scholar 

  5. Zuccoli G, Pipitone N. Neuroimaging finding in acute Wernicke’s encephalopathy: review of the literature. AJR Am J Roentgenol. 2009;192:501–8.

    Article  Google Scholar 

  6. Tanasescu R, Dumitrescu L, Dragos C, Luca D, Oprisan A, Coclitu C, et al. Wernicke’s encephalopathy. In: Tanasescu R, editor. Miscellanea on encephalopathies—a seconf look. 1st ed. Rijeka: IntechOpen; 2012. p. 327–64.

  7. Gui QP, Zhao WQ, Wang LN. Wernicke’s encephalopathy in nonalcoholic patients: clinical and pathological features of three cases and literature review. Neuropathology. 2006;26:231–5.

    Article  Google Scholar 

  8. Caine D, Halliday GM, Kril JJ, Harper CG. Operational criteria for the classification of chronic alcoholics: identification of Wernicke’s encephalopathy. J Neurol Neurosurg Psychiatry. 1997;62:51–60.

    Article  CAS  Google Scholar 

  9. Chiossi G, Neri I, Cavazzuti M, Basso G, Facchinetti F. Hyperemesis gravidarum complicated by Wernickeho encephalopathy: background, case report, and review of the literature. Obstet Gynecol Surv. 2006;61:255–68.

    Article  Google Scholar 

  10. Krapels IP, van Rooij IA, Ocké MC, van Cleef BA, Kuijpers-Jagtman AM, Steegers-Theunissen RP. Maternal dietary B vitamin intake, other than folate, and the association with orofacial cleft in the offspring. Eur J Nutr. 2004;43:7–14.

    Article  CAS  Google Scholar 

  11. Pospíšilová V. Vývoj tváre, ústnej a nosovej dutiny. (Development of face, oral and nasal cavity). In: Kapeller K, Pospíšilová V, editors. Embryológia človeka (Embryology of the Human). 2nd ed. Martin: Osveta; 2001. p. 207–27. (In Slovak).

Download references

Author information

Authors and Affiliations

  1. 1st Department of Internal Medicine, Faculty of Medicine, Slovak Medical University, Bratislava, Slovakia

    Miroslav Žigrai & Viera Smetanová

  2. Department of Neurology, University Hospital, Bratislava, Slovakia

    Karin Gmitterová

  3. Department of Radiology, University Hospital, Bratislava, Slovakia

    Petra Klepancová

  4. Department of Internal Medicine, St. Michael′s Hospital, Bratislava, Slovakia

    Milan Vyskočil

Authors
  1. Miroslav Žigrai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Viera Smetanová
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karin Gmitterová
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Petra Klepancová
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Milan Vyskočil
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Milan Vyskočil.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Žigrai, M., Smetanová, V., Gmitterová, K. et al. Wernicke encephalopathy—a rare complication of hyperemesis gravidarum. Eur J Clin Nutr 74, 663–665 (2020). https://doi.org/10.1038/s41430-020-0592-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41430-020-0592-9

This article is cited by

Search

Advanced search

Quick links