Wenicke's Encephalopathy Due to Hypermesis Gravidarum: A Case Report

Introduction: Wernicke's encephalopathy is a neuropsychiatric syndrome caused by vitamin B1 deficiency, in most cases it is related to heavy alcohol consumption. This report presents the case of a 29-year-old patient with a 14.4-week pregnancy who was diagnosed with Wernicke's encephalopathy associated with hyperemesis gravidarum, in a patient with a history of dissociative symptoms that had required hospitalization, which made it difficult to making the diagnosis. Main symptoms: The patient presented neuropsychiatric symptoms consistent in disorientation in time and space, failure to recognize her relatives, incoherent language, psychomotor agitation and dissociative symptoms. Main diagnoses, therapeutic interventions and results: Magnetic resonance imaging showed edema of the mammillary bodies and the patient's symptoms began to improve when IM thiamine supplementation was started. Conclusion: Although in most cases Wernicke's encephalopathy is associated with heavy alcohol consumption, it can also appear as a complication of hyperemesis in pregnant women, with high maternal and fetal morbidity and mortality, which warrants early detection and treatment of the condition. In addition, the question arises about the fluctuating presentation of its symptoms and whether these are part of a picture of psychiatric aetiology, or are an additional manifestation of Wernicke's encephalopathy.