Hyperemesis gravidarum is associated with nutritional deficiencies, include thiamine deficiency, which can lead to Wernicke's encephalopathy.
Patient selection: pregnant woman with hyperemesis gravidarum
Risk factors:
(1) prolonged and severe hyperemesis
(2) poor nutrition prior to pregnancy
(3) history of ethanol abuse
Clinical features of Wernicke's encephalopathy:
(1) ataxia
(2) nystagmus or ophthalmoplegia
(3) memory loss
(4) altered mental status with confusion, confabulation or delirium
The encephalopathy may be triggered by a glucose infusion.
The brain MRI may show abnormal signal intensities in the thalami, mamillary bodies and/or midbrain.
