title: Hyperemesis gravidarum complicated by Wernicke's encephalopathy.
abstract: BACKGROUND
  Wernicke's encephalopathy is usually associated with alcohol abuse, but can also occur with hyperemesis gravidarum. The effect of delay in thiamine replacement on fetal outcomes is unknown. We present a case of this complication.
  
  
  METHODS
  A primipara with hyperemesis was admitted for mental status changes in her 14th week of pregnancy. Physical examination revealed a lethargic patient with ophthalmoplegia, ataxia, and hyporeflexia. Parenteral thiamine therapy was started. The patient improved rapidly although the ataxia persisted. A spontaneous abortion occurred 2 weeks later.
  
  
  CONCLUSIONS
  Wernicke's encephalopathy can complicate hyperemesis gravidarum. Early thiamine replacement may decrease the chances of spontaneous abortion.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Spruill
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Kuller
mesh_terms: D000022:Abortion, Spontaneous; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000188:drug therapy; D011261:Pregnancy Trimester, First; D013831:Thiamine / Q000008:administration & dosage; D014899:Wernicke Encephalopathy / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D013831:Thiamine