Wernicke’s Encephalopathy in the Context of Hyperemesis Gravidarum: A Case Report and Literature Review

Introduction
Wernicke’s encephalopathy (WE) is a rare but potentially fatal neurological emergency caused by thiamine deficiency. It can occur during pregnancy, especially in cases of prolonged hyperemesis gravidarum.
Case Report

We report the case of a 28-year-old primigravida admitted at 16 weeks of gestation with muscle weakness and suspected polyradiculoneuropathy. Electromyography revealed a sensory-motor axonal polyneuropathy. Secondary worsening with confusion and nystagmus led to the diagnosis of Wernicke’s encephalopathy confirmed by brain MRI. The patient improved following thiamine supplementation.
Discussion

This case illustrates an atypical form of WE with predominant peripheral involvement, which delayed diagnosis. Early treatment with intravenous thiamine enabled partial neurological recovery and prevented severe sequelae.

Conclusion

Any unexplained neurological symptoms in a pregnant woman with prolonged vomiting should raise suspicion for WE. Empirical thiamine supplementation is justified in the presence of clinical doubt.