Optic Discs Swelling Procrastinates Wernicke’s Encephalopathy Associated with Hyperemesis Gravidarum: A Case Report and Review of Literature

Abstract

Wernicke’s encephalopathy following severe hyperemesis gravidarum is an uncommon clinical entity. We describe a rare manifestation of optic discs swelling in a pregnant woman that has caused a diagnostic dilemma. With high index of suspicion of clinical manifestations and radiological evidences, a clinical diagnosis of Wernicke’s encephalopathy was made. Intravenous thiamine therapy was instituted, and prompt improvement of clinical signs was observed. The association of optic discs swelling and Wernicke’s encephalopathy after hyperemesis gravidarum is discussed.

Micronutrient Deficiencies Presenting with Optic Disc Swelling Associated with or without Intracranial Hypertension: A Systematic Review

“…Most cases of optic disc swelling caused by thiamine deficiency (90%; 36/40) [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ] were young women (mean age = 28 years, range = 11–56 years), matching the typical demographic of IIH patients ( Table 2 and Tables S5 and S6 ). The cause of thiamine deficiency was predominately due to reduced intake (62.5%; 25/40) due to anorexia, nausea, vomiting or restrictive diets.…”