Wernicke’s encephalopathy secondary to gestational hyperthyroidism

Wernicke’s encephalopathy precipitated by neuromyelitis optica spectrum disorder and Graves’ disease: A tale of clinical and radiological dilemmas

“…It is hypothesized that thyrotoxicosis initiates a hypermetabolic state, which in turn necessitates increased thiamine utilization. 6,12,13 In our case, intractable vomiting and hiccups on the one hand, and the increased thiamine demand due to decreased dietary intake on the other, may have precipitated WE in the setting of depleted thiamine stores. 6,13 Although different neuropsychiatric disorders have been described in thyrotoxicosis, the role of thiamine deficiency in the synthesis of neuropsychiatric manifestations in thyrotoxicosis remains poorly explored.…”

“…Thiamine is an essential cofactor for two enzymes involved in oxidative metabolism: pyruvate dehydrogenase and α‐ketoglutarate dehydrogenase. It is hypothesized that thyrotoxicosis initiates a hypermetabolic state, which in turn necessitates increased thiamine utilization 6,12,13 . In our case, intractable vomiting and hiccups on the one hand, and the increased thiamine demand due to decreased dietary intake on the other, may have precipitated WE in the setting of depleted thiamine stores 6,13 .…”

Wernicke’s encephalopathy in hyperemesis gravidarum: A systematic review

“…Visual symptoms have been described as a prodromal characteristic of WE in other populations that have forms of malnutrition, such as anorexia nervosa [165], dietary issues [168,169], and some cancers [170]. In alcoholics, patients with WE often lack any awareness of their own illness, reducing the chance they will present to emergency services with visual disturbances [141,144]. In clinical practice, visual disturbance in HG specifically warrants attention for possible thiamine deficiency.…”

An uncommon presentation of Wernicke-Korsakoff's syndrome in pregnancy: Case report

“…While WE has been classically associated with alcoholism, it has increasingly been reported in other disorders causing malnutrition and malabsorption [7] .…”

“…We report the case of a pregnant women affected by pre-gestational hyperthyroidism that caused an uncommon presentation of WE. To our knowledge, similar cases reported in the literature are extremely limited, as the majority of cases of WE in pregnancy are related to transient gestational hyperthyroidism [ 6 , 7 ].…”