2022, Number 01
<< Back Next >>
Ginecol Obstet Mex 2022; 90 (01)
Beyond vomiting. Wernicke encephalopathy due to hyperemesis gravidarum
Sillero-Castillo, Ana; Martínez-Palazón, Sara; Torres-Aguilar, M Rosario; Baena-Palomino, Pablo; Sanz-Fernández, Gema; Granell-Escobar, M Reyes
Language: Spanish
References: 22
Page: 96-102
PDF size: 304.10 Kb.
ABSTRACT
Background: Hyperemesis gravidarum is a serious condition that can affect up to 2% of pregnant women. This condition can lead to Wernicke's encephalopathy due to a deficiency in vitamin B1 which, in its active form, plays a decisive role in neuronal metabolism.
Objective: To contribute to the understanding of preventive aspects and diagnosis and to insist on the importance of early treatment to reduce morbidity and maternal and perinatal mortality derived from this condition.
Clinical case: Patient 18 weeks pregnant who in the context of hyperemesis gravidarum resulted in Wernicke's encephalopathy complicated by severe fetal hydrocephalus.
Conclusions: This neurological emergency is characterized by a classic triad: ataxia, confusion and ophthalmoplegia that does not always manifest in its entirety, making diagnosis difficult. If diagnosis and treatment are not established early, irreversible complications may arise.
REFERENCES
Gill BK, Jindal P, Kumar R, Tiwari S, Sharma N, Goel A. A study of thyroid status in hyperemesis gravidarum. Indian J Clin Biochem 2007; 22 (1): 148-51. doi: 10.1007/BF02912900.2020
Matthews A, Haas DM, O’Mathúna DP, Dowswell T. Interventions for nausea and vomiting in early pregnancy. Cochrane Database of Systematic Reviews 2014; (3). doi: 10.1002/14651858.CD007575
Fejzo MS, Trovik J, Grooten IJ et al. Nausea and vomiting of pregnancy and hyperemesis gravidarum. Nat Rev Dis Primers 2019; 5 (1): 62. doi: 10.1038/s41572-019-0110-3
Gangi SD, Gizzo S, Patrelli TS, Saccardi C, D’Antona D, Nardelli GB. Wernicke’s encephalopathy complicating hyperemesis gravidarum: from the background to the present. J Matern Fetal Neonatal Med 2012; 25 (8): 1499-504. doi: 10.3109/14767058.2011.629253
Grandez JA, Fernández JL, Castañeda D, Cruz R, Angulo A, Valdivia R. Enfermedad de Wernicke Korsakoff en hiperémesis gravídica: presentación de un caso en el Hospital Hipólito Unanue de Lima, Perú, y revisión de la literatura. Rev Colomb Obstet Ginecol 2013; 64 (3): 333-7. https://revista.fecolsog.org/index.php/rcog/article/view/109
MacGibbon KW, Fejzo MS, Mullin PM. Mortality secondary to hyperemesis gravidarum: a case report. Women’s Health & Gynecology 2015; 1 (2): 1-7. https://scientonline.org/open-access/mortality-secondary-to-hyperemesis-gravidarum-a-case-report.pdf
Zias N, Chroneou A, Tabba MK, et al. Post tracheostomy and post intubation tracheal stenosis: Report of 31 cases and review of the literature. BMC Pulm Med 8, 18 (2008). https://doi.org/10.1186/1471-2466-8-18
Cotaina GL, Lázaro GVE, Roca AM, Lahoz PI, Rodríguez LL, Campillos-Maza JM. Encefalopatía de Wernicke en gestante con hiperémesis gravídica grave. Ginecol Obstet Mex 2017; 85 (2): 92-101.
Oudman E, Wijnia JW, Oey M, Dam MV, Painter RC, Postma A. Wernicke’s encephalopathy in hyperemesis gravidarum: A systematic review. Eur J Obstet Gynecol Reprod Biol 2019; 236: 84-93. doi: 10.1016/j.ejogrb.2019.03.006 2019
Sánchez MM, Teijelo AI, García RM, Moro J, Leiva A, Tejerizo A, et al. Encefalopatía de Wernicke y gestación. Prog Obstet Ginecol 2000; 43 (4): 225-28. https://www.elsevier.es/es-revista-progresos-obstetricia-ginecologia-151-articulo-encefalopatia-wernicke-gestacion-13012435
Žigrai M, Smetanová V, Gmitterová K, Klepancová P, Vyskočil M. Wernicke encephalopathy -a rare complication of hyperemesis gravidarum. Eur J Clin Nutr 2020; 74 (4): 663-65. doi: 10.1038/s41430-020-0592-9
Cano-Paniagua A, Amariles-Muñoz PJ. Medicamentos causantes de hepatotoxicidad en el embarazo: revisión estructurada. Revista Colombiana de Gastroenterología 2017; 32 (1): 38-46. https://doi.org/10.22516/25007440.128
Talib V, Sultana S, Hamad A, Yaqoob U. Wernicke encephalopathy due to hyperemesis gravidarum in pregnancy: A case report. Cureus 2018; 10 (7). doi:10.7759/cureus.2991
Liu YT, Fuh JL, Lirng JF, Li AF, Ho DM, Wang SJ. Correlation of magnetic resonance images with neuropathology in acute Wernicke’s encephalopathy. Clin Neurol Neurosurg 2006; 108 (7): 682-7. doi: 10.1016/j.clineuro.2005.05.010
Anand P, Gold DR. Nystagmus from Wernicke’s Encephalopathy. N Engl J Med 2017; 377. doi: 10.1056/NEJMicm1615499
Shah VS, Shanmugam M, Kowsalya A, Srinivasan KG, Siddappa P, Neethiarasu V, et al. Gestational Wernicke's encephalopathy. Neurol India. 2017; 65 (5): 1190-1191. doi: 10.4103/neuroindia.NI_35_17
Aneja T, Chaturvedula L, Nair P, Barathi D, Keepanasseril A. Complete recovery in Wernicke’s encephalopathy complicating hyperemesis gravidarum. BMJ Case Rep 2019; 12 (2). doi: 10.1136/bcr-2018-227530
Garla VV, Yanes-Cardozo L, Yousuf T, Ahmad S. Wernicke’s encephalopathy secondary to gestational hyperthyroidism. BMJ Case Rep 2017. doi: 10.1136/bcr-2017-221644
Ventura A, Mafe MC, Bourguet M, Tornero C. Wernicke’s encephalopathy secondary to hyperthyroidism and ingestion of thiaminase-rich products. Neurologia 2013; 28 (4): 257-9. doi: 10.1016/j.nrl.2012.01.005
Kloss O, Eskin M, Suh M. Thiamin deficiency on fetal brain development with and without prenatal alcohol exposure. Biochem Cell Biol 2018; 96 (2): 169-77. doi: 10.1139/bcb-2017-0082
Doss A, Mahad D and Romanowski Ch. Wernicke Encephalopathy: Unusual findings in nonalcoholic patients. J Comput Assist Tomogr 2003; 27 (2): 235-40. doi: 10.1097/00004728-200303000-00022
Masselli G, Bernieri MG, De Stefano MG, Maragno AM, Patti S, Galoppi P et al. Magnetic Resonance Imaging and H-proton Spectroscopy assessment of maternal and foetal brains in a case of pregnancy-associated Wernicke encephalopathy. J Obstet Gynaecol 2016; 36 (8): 996-8. doi: 10.1080/01443615.2016.1217507