Wernicke-Korsakoff Syndrome Associated with Hyperemesis Gravidarum

Yoon, Chang Kyoon; Chang, Moo Hwan; Lee, Dong Cho

doi:10.3341/kjo.2005.19.3.239

Cited by 18 publications

(9 citation statements)

References 7 publications

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“…However, it is crucial to recognize other rare causes such as malignancy, disseminated tuberculosis, acquired immunodeficiency syndrome, starvation, chronic hemodialysis, glucose infusion to a chronically malnourished person and persistent vomiting such as hyperemesis gravidarum. [ 3 4 ]…”

Section: Discussionmentioning

confidence: 99%

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Ocular manifestations in a case of Wernicke's encephalopathy due to hyperemesis gravidarum

2018

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Section: Discussionmentioning

confidence: 99%

“…This is especially important in pregnancy, as it could result in miscarriage, intrauterine growth retardation and fetal death. [ 3 4 5 ]…”

Section: Discussionmentioning

confidence: 99%

Ocular manifestations in a case of Wernicke's encephalopathy due to hyperemesis gravidarum

2018

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“…9 Pharmakotherapie der HG (entsprechend dem in l " Abb. 1 skizzierten Behandlungsschema) [60,62,[90][91][92]. 1 Kriterium reicht aus: 2 Kriterien oder mehr müssen erfüllt sein:…”

Section: Medikamentöse Therapie Der Hgunclassified

Hyperemesis gravidarum

Böer

Hoopmann

Hübner

et al. 2011

Geburtsh Frauenheilk

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Einleitung ! Die Symptome Übelkeit und Erbrechen sind in bis zu 80 % aller Schwangerschaften nachweisbar und damit insbesondere zwischen der 4. bis 10. Schwangerschaftswoche als physiologisch anzusehen [1]. Da vonseiten der Gesellschaft gegenüber dieser Begleiterscheinung eine hohe Akzeptanz besteht, wird sie in der Regel von der betroffenen Schwangeren weitreichend akzeptiert. Nur in ca. 2 % der Fälle bestehen die Symptome isoliert am Morgen. Meist treten sie über den Tag verteilt auf und sistieren im Allgemeinen ab der 14. SSW [2]. In einer prospektiven Untersuchung an 160 betroffenen Schwangeren waren in der 14. Schwangerschaftswoche 50 % der Frauen, in der 22. SSW über 90 % der Probandinnen beschwerdefrei [3]. In bis zu 20 % aller Schwangerschaften persistiert die Übelkeit über den gesamten Verlauf der Gravidität [1, 4]. Gegenüber der Emesis gravidarum liegt die Inzidenz der Hyperemesis gravidarum (HG), also dem übermäßigen Erbrechen in der Schwangerschaft, weltweit zwischen 0,5-2%. Es bestehen Zusammenfassung ! Circa 80% aller Frauen leiden während der Schwangerschaft an Übelkeit und Erbrechen. In bis zu 20% der Fälle können die Symptome über die gesamte Gravidität beobachtet werden. Die Ursache ist nach heutigem Kenntnisstand multifaktoriell und nicht endgültig geklärt. Die Betroffenen zeigen ein über den Tag hinweg übermäßig häufiges Erbrechen. Die weiteren Beschwerden sind häufig unspezifisch. Für die Diagnose richtungsweisend sind v. a. die Klinik der Patientin und die Ergebnisse der Laboruntersuchung (Elektrolytentgleisung, Hämatokriterhöhung, Ketonurie etc.). Die Behandlung ist symptomatisch. Neben der medikamentösen Therapie (Vitamin B 6 , Antihistaminika, Anticholinergika und andere niedrig dosierte Antiemetika sowie gastrointestinal wirksame Medikamente) haben auch naturheilkundliche Verfahren (Akupunktur, Akupressur, Ingwer etc.) ihren Stellenwert. Darüber hinaus sollte die Indikation zur psychosomatischen und -therapeutischen Begleitbehandlung groß-zügig gestellt werden, da davon auszugehen ist, dass psychologische Faktoren in der Pathogenese eine gewichtige Rolle spielen. Bei ausgeprägtem Verlauf (Hyperemesis Grad II) ist eine stationäre Behandlung indiziert.Abstract ! About 80 % of pregnant women suffer from nausea and vomiting and about 20 % will remain symptomatic throughout the whole course of pregnancy. The origin is not fully clarified and is believed to be multifactorial. The key symptoms that point towards the diagnosis of hyperemesis gravidarum consist of the clinical presentation and changes in the blood and urine analysis (increasing hematocrit, ketonuria, dysbalance of electrolytes, etc.). The treatment is symptomatic and consists of vitamin B 6 , antihistaminics, anticholinergics and other low dosed anti-emetics. Alternative approaches such as acupuncture, acupressure, ginger, etc. also play an important role. As psychological factors may often be of importance, psychosomatic treatment should always be considered. If the clinical symptoms are more pronounced (hyperemesis gravidarum l...

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“…Shortness of breath before treatment was associated with lower median (range) admission extrapolated basal ETK (p = 0.002), whilst shortness of breath after treatment was not. In the Wenicke-Korsakoff syndrome, ataxia is a cardinal feature and dizziness has been reported [9]. Thiamin, especially as thiamin triphosphate, is important in brain function [10].…”

Section: Introductionmentioning

confidence: 99%

Thiamin supplementation does not reduce the frequency of adverse events after anti-malarial therapy among patients with falciparum malaria in southern Laos

Mayxay

Khanthavong

Cox

et al. 2014

Malar J

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BackgroundIn a recent study one third of Lao patients presenting with uncomplicated Plasmodium falciparum malaria had biochemical evidence of thiamin deficiency, which was associated with a higher incidence of adverse events. Thiamin supplementation might, therefore, reduce adverse events in this population.MethodsAn exploratory, double-blind, parallel group, placebo-controlled, superiority trial of thiamin supplementation in patients of all ages with uncomplicated and severe falciparum malaria was conducted in Xepon District, Savannakhet Province, southern Laos. Patients were randomly assigned to either oral thiamin 10 mg/day for 7 days immediately after standard anti-malarial treatment then 5 mg daily until day 42, or identical oral placebo.ResultsAfter interim analyses when 630 patients (314 in thiamin and 316 in placebo groups) had been recruited, the trial was discontinued on the grounds of futility. On admission biochemical thiamin deficiency (alpha ≥ 25%) was present in 27% of patients and 9% had severe deficiency (alpha > 31%). After 42 days of treatment, the frequency of thiamin deficiency was lower in the thiamin (2%, 1% severe) compared to the placebo (11%, 3% severe) groups (p < 0.001 and p = 0.05), respectively. Except for diarrhoea, 7% in the placebo compared to 3% in the thiamin group (p = 0.04), and dizziness on day 1 (33% vs 25%, p = 0.045), all adverse events were not significantly different between the groups (p > 0.05). Clinical, haematological, and parasitological responses to treatment did not differ significantly between the two groups.ConclusionThiamin supplementation reduced biochemical thiamin deficiency among Lao malaria patients following anti-malarial drug treatment, but it did not reduce the frequency of adverse events after anti-malarial therapy or have any detected clinical or parasitological impact.Trial registrationISRCTN 85411059

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Wernicke-Korsakoff Syndrome Associated with Hyperemesis Gravidarum

Abstract: If a pregnant women has symptoms of severe vomiting along with other ocular findings such as retinal hemorrhage or restricted extraocular movement, one must suspect the diagnosis of Wernicke-Korsakoff syndrome, and should start appropriate treatment immediately.

Cited by 18 publications

References 7 publications

Ocular manifestations in a case of Wernicke's encephalopathy due to hyperemesis gravidarum

Ocular manifestations in a case of Wernicke's encephalopathy due to hyperemesis gravidarum

Hyperemesis gravidarum

Thiamin supplementation does not reduce the frequency of adverse events after anti-malarial therapy among patients with falciparum malaria in southern Laos

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