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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Postgrad+Med
2016 ; 62
(4
): 260-263
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Wernicke s encephalopathy due to hyperemesis gravidarum: Clinical and magnetic
resonance imaging characteristics
#MMPMID27763485
Ashraf VV
; Prijesh J
; Praveenkumar R
; Saifudheen K
J Postgrad Med
2016[Oct]; 62
(4
): 260-263
PMID27763485
show ga
Hyperemesis gravidarum-induced Wernicke's encephalopathy (WE) is an
underestimated condition. The purpose of this study is to improve its awareness
and early diagnosis. We report five cases of WE secondary to hyperemesis
gravidarum. Classic triad of encephalopathy, ataxia, and ocular signs was seen in
four out of five patients. Two unusual features noted in this series were
papilledema in one patient and severe sensory-motor peripheral neuropathy in one
patient. Magnetic resonance imaging (MRI) was abnormal in all the five patients,
and high signal in medial thalamus and surrounding the aqueduct was the most
common abnormality (5/5). Involvement of caudate nucleus was seen in two patients
with severe psychosis, and two patients had bilateral cerebellar peduncle
involvement. Median time delay between onset of neurological symptoms and
diagnosis was 7 days. All patients improved with thiamine, but minor sequelae
were seen in four patients at 12 months follow-up. One patient had a fetal
demise. Hyperemesis gravidarum-induced WE is a common cause of maternal
morbidity. Typical MRI findings of symmetric medial thalamic and periaqueductal
signal changes may permit a specific diagnosis. A delay in diagnosis, therefore
treatment, leads to worse prognosis.