Annals of Medicine and Surgery · 8 authors, 3 centres
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This case report describes a 25-year-old pregnant woman with Wernicke encephalopathy, who presented with areflexic flaccid tetraparesis due to hyperemesis gravidarum. Her neurological condition significantly improved after treatment with intravenous thiamine.
She presented with areflexic flaccid tetraparesis, ataxia, and low serum thiamine. Brain and spinal MRIs, along with EMG, were normal. She was initially managed for hypokalemia and given antiemetics, but without improvement. Upon diagnosis of Wernicke encephalopathy, she received parenteral thiamine. The patient showed significant improvement by the 19th day of hospitalization and was able to walk, being discharged on the 37th day with mild residual ataxia. The report highlights that normal MRI does not exclude Wernicke encephalopathy and that early thiamine administration is crucial for improving outcomes in pregnant women with hyperemesis gravidarum.
