thiamine in hyperemesis gravidarum

Hyperemesis gravidarum is the most common condition requiring hospital care for women during the first 20 weeks of pregnancy and may lead to malnutrition, dehydration, and vitamin deficiencies. Depletion of vitamins such as thiamine may result in the development of Wernicke encephalopathy, a severe neurological disorder that can increase the risk for mortality and morbidity for the mother and fetus. A lack of awareness regarding the relationship of hyperemesis gravidarum and Wernicke encephalopathy may result in delayed treatment and disease management...

Wernicke encephalopathy (WE) is a rare neurological disorder that results from vitamin B1 (Thiamin) deficiency, classically characterized by the triad of ophtalmoplagia, altered consciousness, and ataxia. WE is often associated with alcoholism, malnutrition, or gastrointestinal diseases with malabsorption. The association of «gravidarum hyperemesis» and WE seems to be underestimated. We report a 24-year-old pregnant woman with hyperemesis gravidarum, who presented with decreased visual acuity of both eyes...

Wernicke encephalopathy (WE) is a rare but life-threatening syndrome that is commonly associated with chronic alcoholism. It has also been found to be associated with malnutrition, prolonged parenteral nutrition, hemodialysis, hyperemesis gravidarum, gastroplasty, and AIDS. It usually presents as a clinical triad of confusion, ophthalmoplegia, and gait ataxia. Nystagmus is usually the most common and earliest ophthalmologic sign. We report a case of non-alcoholic WE in a patient who had prior bariatric surgery and was treated for malnutrition and sepsis, with nystagmus being the initial presentation...

Wernicke Encephalopathy (WE) is a neurological acute syndrome related to vitamin B1 deficiency and is relatively common in patients with chronic alcoholism. In the case of Hyperemesis Gravidarum, thiamine body stores become unable to meet the increased demand, resulting in acute deficiency. WE is associated with typical clinical and radiological findings. Treatment pathways rely on thiamine replacement. The case herein reported is centered around a 33-year-old diabetic patient at 12 weeks of gestation, with WE due to hyperemesis gravidarum...

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Wernicke's encephalopathy (WE) is an acute neurological disorder caused by severe thiamine deficiency that manifests with a common range of clinical features including a triad of global confusion state, ophthalmoplegia, and ataxia. Though frequently associated with the alcohol-dependent population, WE has been seen in other patients where it often goes undiagnosed presumably due to rarity and variable clinical indications. In this case report, we highlight the importance of WE being considered as a differential diagnosis of acute encephalopathy particularly in women who have experienced fetal demise in conjunction with signs of malnourishment from hyperemesis gravidarum...

Wernicke encephalopathy is an acute, reversible neurological disorder, which, if untreated, can develop into Korsakoff syndrome. Commonly associated with alcohol use disorder, Wernicke encephalopathy is a metabolic disorder caused by a deficiency of thiamine, vitamin B1. This case report presents a clinical manifestation of Wernicke encephalopathy, in which a 22-year-old pregnant female with hyperemesis gravidarum and significant weight loss developed acute metabolic encephalopathy. Diagnostic imaging played an important role both in diagnosing the patient acutely in the hospital and during a follow-up visit one year after treatment...

OBJECTIVE: Wernicke-Korsakoff syndrome (WKS) is a neurological disorder caused by the lack of thiamine (vitamin B1) and includes Wernicke encephalopathy and the later stage of Korsakoff amnesic syndrome. WKS could be secondary to malnutrition, including Hyperemesis Gravidarum (HEG), which is characterized by severe vomiting during pregnancy. We present a case of HEG resulting in suspected WKS where neuropsychological evaluation clarified cognitive status with complex cultural, language, and educational factors...

Wernicke's encephalopathy (WE) is a condition resulting from thiamine deficiency and has been linked to conditions such as hyperemesis gravidarum, anorexia nervosa, hemodialysis, and chronic alcoholism. The aim of the report is to outline the ocular manifestations of WE. We present the case of a 33-year-old woman, who presented in her second trimester of pregnancy with persistent vomiting, nystagmus, ataxia, global confusion as well as hypotonia, and tremors. She was subsequently diagnosed with WE complicating pregnancy...

Wernicke's encephalopathy (WE) is an acute neuropsychiatric emergency due to thiamine deficiency. This report includes a case of a young pregnant female in her second trimester (17th weeks) complaining of hyperemesis gravidarum, who, due to excessive vomiting, developed severe vitamin B1 deficiency, leading to WE and Korsakoff's psychosis. The typical triad of confusion, ocular signs, and ataxia is fundamental for the diagnosis of WE, yet not all cases present with the entire triad; however, our patient presented with all the symptoms...

Hyperemesis gravidarum (HG) is a severe and debilitating condition characterized by persistent and excessive nausea and vomiting during pregnancy (NVP), often leading to significant maternal and fetal morbidity. This literature review aims to provide a scientifically comprehensive overview of HG within the context of the emergency room (ER) setting. This review aims to enhance understanding and improve the management of HG cases presented to the ER by synthesizing current knowledge and evidence-based practices...

Wernicke-Korsakoff syndrome (WKS) is caused by severe thiamine (vitamin B1) deficiency and can lead to chronic deficits. In this case, a 22-year-old pregnant patient at 10 1/7 weeks of gestation presented to the emergency department with malaise, asthenia, headache, weakness, vomiting, and weight loss of 12 kg. Pancreatitis and hepatic steatosis were considered but ruled out, and cholecystolithiasis was confirmed by ultrasound. After significant neurological deterioration, the patient underwent a cranial MRI that revealed suggestive findings in the thalamus consistent with WKS...

BACKGROUND: Hyperemesis gravidarum (HG) is severe pregnancy sickness, often leading to dehydration, weight loss and electrolyte disturbances. Little is known about nutritional intake and its consequences in those affected. The aim of this study was to explore the first trimester nutritional intake and clinical characteristics in those with severe sickness. METHOD: Recruitment was via the social media accounts of national pregnancy charities. The eligibility criteria were as follows: between 6 and 11 weeks pregnant, age ≥18 years and residing in the UK...

Wernicke's encephalopathy (WE) is a neurologic emergency requiring timely intravenous thiamine supplementation to prevent permanent neurologic deficits. Historically, the WE diagnosis was limited to individuals with alcohol use disorder. However, it is now widely recognized to occur in patients who are chronically malnourished, post-bariatric surgery, pregnant with hyperemesis gravidarum, and with severe anorexia nervosa. Here we present a young woman who developed WE after undergoing a recent sleeve gastrectomy followed by protracted emesis for several days...

Wernicke encephalopathy (WE) is a combination of neurological findings including confusion, ataxia, and ophthalmoplegia. It is most commonly associated with patients who have a history of alcohol abuse. This aspect leads to the majority of cases going undiagnosed in non-alcoholic patients who have other potential thiamine deficiency-causing conditions such as malignancy, chronic kidney disease (CKD) on hemodialysis, hyperemesis gravidarum, and psychiatric disorders leading to starvation and malnourishment. Here we present the case of a 59-year-old female patient with decompensated bipolar disorder who came in with altered mental status and multiple syncopal episodes...

UNLABELLED: Nausea and vomiting affect up to 80% of all pregnancies, sometimes so severely that the condition of hyperemesis gravidarum (HG) is established. HG may in addition be a predisposing factor for Wernicke encephalopathy (WE), a severe and life-threatening condition due to vitamin B1 (thiamin) deficiency. If untreated, WE may progress to Korsakoff's syndrome, an irreversible cognitive disorder. We reported a case that recently occurred at our clinic and performed a systematic review of the literature to investigate the clinical presentation, maternal and perinatal outcomes and treatment of WE in women with HG...

UNLABELLED: Wernicke's encephalopathy is an acute neuropsychiatric syndrome resulting from thiamine deficiency, which is associated with significant morbidity and mortality. The diagnosis of Wernicke's encephalopathy is based on the clinical manifestations and rapid reversal of symptoms with thiamine. CASE PRESENTATION: The authors present the case of a 25-year-old female patient at the 19th week of gestation (Gravid 1 para 0) with an unremarkable medical history who was admitted to the hospital for an areflexic flaccid tetraparesis with ataxia after persistent vomiting...

Wernicke encephalopathy (WE) is an acute neurological syndrome caused by thiamine (vitamin B1) deficiency. This disorder manifests as a triad of gait ataxia, confusion, and vision abnormalities. The absence of a full triad does not rule out WE. Because of its vague presentation, WE is commonly missed in patients with no history of alcohol abuse. Other risk factors for WE include bariatric surgery, hemodialysis, hyperemesis gravidarum, and malabsorption syndromes. WE is a clinical diagnosis that can be confirmed with an MRI of the brain as hyperintensities in the mammillary bodies, periaqueductal area, thalami, and hippocampus...

BACKGROUND: Wernicke-Korsakoff syndrome is a neuropsychiatric disorder caused by thiamine deficiency composed of two related disorders accounting for an acute presentation and chronic progression. Hyperemesis gravidarum presents a significant risk factor for Wernicke-Korsakoff syndrome as symptoms may rapidly progress in the setting of pregnancy. We present the first-reported case of hyperemesis-gravidarum-associated Wernicke encephalopathy in a patient in the first half of pregnancy in which a missed diagnosis led to septic shock, fetal demise, and eventual profound Korsakoff syndrome...

Wernicke's encephalopathy (WE) is a neuropsychiatric condition caused by thiamine deficiency often associated with alcoholism. Other less common causes include prolonged gastroenterology problems or dietary insufficiencies associated with hyperemesis gravidarum, bariatric surgery, and eating disorders. Prolonged WE without proper treatment can lead to the chronic and irreversible condition, Wernicke-Korsakoff syndrome. Despite being known for its classic triad of clinical symptoms (nystagmus/ophthalmoplegia, gait ataxia, and confusion), WE patients more commonly present with non-specific symptoms of altered mental status...