[A rare complication of vomiting in pregnancy: Wernicke's encephalopathy].
Gayet-Wernicke syndrome is a rare neurological pathology due to a deficit in vitamin B1. It occurs in alcoholics but several reports have been published of cases in a context of intractable vomiting. The frequency is probably under-estimated because there have been many cases described at autopsy. The diagnosis is clinical with the triad (found in 60% of cases) of mental confusion, oculomotor disorders and ataxia. MRI can confirm the diagnosis by hyper signal images most frequently in a peri-acqueductal location, the thalamus and mamillary bodies. We report 3 observations of Gayet-Wernicke encephalopathy discovered in a context of hyperemesis gravidarum. These 3 cases, which occurred within the past two years in the West of France, give us the opportunity to assess 3 different outcomes for this pathology. In a second section we review the main publications in the literature. Hyperemesis gravidarum is a frequent pathology and can be the cause of serious neurological complications. Early vitamin supplementation should be instituted in case of severe vomiting in order to ensure the pregnancy can continue together with the mother's well-being.
Eboué
C
C
Service de Gynécologie Obstétrique et de Médecine de la Reproduction, CHU de Caen, boulevard Georges-Clémenceau, 14033 Caen Cedex. cyril.eboue@wanadoo.fr
Carlier-Guérin
C
C
de La Sayette
V
V
Grall
J-Y
JY
Herlicoviez
M
M
D000022:Abortion, Spontaneous; D000328:Adult; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000175:diagnosis*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000209:etiology; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D014839:Vomiting / Q000209:etiology; D014899:Wernicke Encephalopathy / Q000150:complications* / Q000175:diagnosis*