Hyperemesis gravidarum induced Wernicke's encephalopathy: Serial clinical, electrophysiological and MR imaging observations

Netravathi, M; Sinha, Sanjib; Taly, AB; Bindu, Parayil Sankaran; Bharath, Rose Dawn

doi:10.1016/j.jns.2009.05.004

Cited by 34 publications

(43 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thiamine pyrophosphate is predominantly found in the brain and is an important cofactor for enzymes involved in the pentose phosphate pathway 1,3 . Deficiency of thiamine thus affects energy metabolism, more profoundly in tissues with high thiamine turnover such as neural parenchyma ultimately resulting in cell death from necrosis or apoptosis 2,3 .…”

Section: Discussionmentioning

confidence: 99%

“…Deficiency of thiamine thus affects energy metabolism, more profoundly in tissues with high thiamine turnover such as neural parenchyma ultimately resulting in cell death from necrosis or apoptosis 2,3 . side-effects, empirical treatment with thiamine in the form of multivitamins is usually the norm.…”

Section: Discussionmentioning

confidence: 99%

“…Another hypothesis involves a form of vasculopathy 16,17 . There is usually not much difference between alcoholic and non-alcoholic WE but long-standing thiamine deficiency as occurs more often in alcoholics may show associated vermian atrophy and contrast enhancement of the mammillary bodies 3 which is due to blood-brain barrier disruption and a feature of long-term thiamine deficiency 19,20 . These patients may have associated anterior corpus callosum atrophy whereas splenial atrophy is seen with non-alcoholic WE 21 .…”

Section: Discussionmentioning

confidence: 99%

“…Involved areas included the medial tha- WE of pregnancy has been attributed to poor nutritional intake, increased demands of pregnancy and depleted thiamine stores 1 . Hyperemesis leads to lowered thiamine levels 3 . All our patients were underweight and appeared malnourished.…”

Section: Case Seriesmentioning

confidence: 99%

“…It occurs due to acute or chronic deficiency of thiamine, the first vitamin in the B series. This disorder may be associated with alcoholism, prolonged starvation, hyperemesis gravidarum, malnutrition, malignant disorders, gastrointestinal disorders, chronic kidney disease or dialysis, thyrotoxicosis, anorexia nervosa, pyloric stenosis, organ transplantation, or total parenteral nutrition [1][2][3] . Diagnosing the acute form of WE is very important as it is potentially treatable and the patient may have a complete neurological recovery.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Wernicke's Encephalopathy following Hyperemesis Gravidarum

Kotha

Souza

2013

Neuroradiol J

View full text Add to dashboard Cite

SUMMARY -Wernicke's encephalopathy (WE) due to causes other than chronic alcohol abuse is an uncommon and often misdiagnosed condition. In the setting of hyperemesis gravidarum, an acute deficiency of thiamine results from body stores being unable to meet increased metabolic demands. The condition produces typical clinical and radiological findings and when diagnosed early and treated promptly has a good prognosis. Magnetic resonance imaging (MRI) is sensitive and specific for diagnosis. We describe three patients with hyperemesis gravidarum who developed WE, and highlight a range of clinical and imaging features important for appropriate diagnosis. A high degree of clinical suspicion is essential. Treatment is often empirical pending results of investigation, and consists of parenteral repletion of thiamine stores. Reversal of MRI findings parallels clinical improvement. Neurologic outcomes are usually good, but half the pregnancies complicated by this condition do not produce healthy children.

show abstract