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Visual loss and optic neuropathy associated with Wernicke's encephalopathy in hyperemesis gravidarum

Wernicke's encephalopathy (WE) is a potentially fatal neuropsychiatric syndrome precipitated by thiamine deficiency due to a variety of causes such as chronic severe alcoholism, starvation, and prolonged intravenous feeding. WE has also been observed rarely in the clinical setting of hyperemesi...

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Autores principales: Palakkuzhiyil, Naseem, Rehiman, Sherinas, Manoj, P. P. Baby, Hameed, Shahul, Uvais, N. A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482737/
https://www.ncbi.nlm.nih.gov/pubmed/31041282
http://dx.doi.org/10.4103/jfmpc.jfmpc_121_19
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author Palakkuzhiyil, Naseem
Rehiman, Sherinas
Manoj, P. P. Baby
Hameed, Shahul
Uvais, N. A.
author_facet Palakkuzhiyil, Naseem
Rehiman, Sherinas
Manoj, P. P. Baby
Hameed, Shahul
Uvais, N. A.
author_sort Palakkuzhiyil, Naseem
collection PubMed
description Wernicke's encephalopathy (WE) is a potentially fatal neuropsychiatric syndrome precipitated by thiamine deficiency due to a variety of causes such as chronic severe alcoholism, starvation, and prolonged intravenous feeding. WE has also been observed rarely in the clinical setting of hyperemesis gravidarum. Here, we report the case of a 34-year-old pregnant woman who presented with reduced vision, gaze-evoked nystagmus, and postural imbalance preceded by 2 weeks of hyperemesis. Fundus examination showed features consistent with papillitis. Magnetic resonance imaging (MRI) showed T2WI, FLAIR, and diffusion-weighted imaging MR images showing hyperintensity in dorsomedial thalami and periaqueductal grey matter with diffusion restriction. She was diagnosed with WE based on history, clinical examination findings, and MRI findings and was treated with injectable thiamine. She showed marked improvement in vision and nystagmus within 3 days. Our case is a rare presentation of WE in a pregnant woman with hyperemesis gravidarum.
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spelling pubmed-64827372019-04-30 Visual loss and optic neuropathy associated with Wernicke's encephalopathy in hyperemesis gravidarum Palakkuzhiyil, Naseem Rehiman, Sherinas Manoj, P. P. Baby Hameed, Shahul Uvais, N. A. J Family Med Prim Care Case Report Wernicke's encephalopathy (WE) is a potentially fatal neuropsychiatric syndrome precipitated by thiamine deficiency due to a variety of causes such as chronic severe alcoholism, starvation, and prolonged intravenous feeding. WE has also been observed rarely in the clinical setting of hyperemesis gravidarum. Here, we report the case of a 34-year-old pregnant woman who presented with reduced vision, gaze-evoked nystagmus, and postural imbalance preceded by 2 weeks of hyperemesis. Fundus examination showed features consistent with papillitis. Magnetic resonance imaging (MRI) showed T2WI, FLAIR, and diffusion-weighted imaging MR images showing hyperintensity in dorsomedial thalami and periaqueductal grey matter with diffusion restriction. She was diagnosed with WE based on history, clinical examination findings, and MRI findings and was treated with injectable thiamine. She showed marked improvement in vision and nystagmus within 3 days. Our case is a rare presentation of WE in a pregnant woman with hyperemesis gravidarum. Wolters Kluwer - Medknow 2019-03 /pmc/articles/PMC6482737/ /pubmed/31041282 http://dx.doi.org/10.4103/jfmpc.jfmpc_121_19 Text en Copyright: © 2019 Journal of Family Medicine and Primary Care http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Palakkuzhiyil, Naseem
Rehiman, Sherinas
Manoj, P. P. Baby
Hameed, Shahul
Uvais, N. A.
Visual loss and optic neuropathy associated with Wernicke's encephalopathy in hyperemesis gravidarum
title Visual loss and optic neuropathy associated with Wernicke's encephalopathy in hyperemesis gravidarum
title_full Visual loss and optic neuropathy associated with Wernicke's encephalopathy in hyperemesis gravidarum
title_fullStr Visual loss and optic neuropathy associated with Wernicke's encephalopathy in hyperemesis gravidarum
title_full_unstemmed Visual loss and optic neuropathy associated with Wernicke's encephalopathy in hyperemesis gravidarum
title_short Visual loss and optic neuropathy associated with Wernicke's encephalopathy in hyperemesis gravidarum
title_sort visual loss and optic neuropathy associated with wernicke's encephalopathy in hyperemesis gravidarum
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482737/
https://www.ncbi.nlm.nih.gov/pubmed/31041282
http://dx.doi.org/10.4103/jfmpc.jfmpc_121_19
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