Gayet-Wernicke Encephalopathy: About an Uncommon Case Report - Abstract
Background: Gayet-Wernicke encephalopathy is a rare but serious deficiency encephalopathy caused by a deficiency of thiamine (vitamin B1). It is frequently seen in heavy alcohol users, but can sometimes occur in other circumstances. We hereby report an uncommon case of Gayet-Wernicke encephalopathy complicating vomiting in pregnancy. Case Presentation: We hereby report an uncommon case of a 32-year-old woman, gravida 1 para 1, admitted to our structure with incoercible gravid vomiting of more than four weeks in a progressive pregnancy of 12 weeks of amenorrhea. The patient was transferred to the intensive care unit and was given rehydration with isotonic saline, potassium recharging via potassium repletion via a central venous line and antiemetic treatment. The evolution was favorable on the hemodynamic and biological patterns but the patient remained disoriented and apathetic with the appearance of nystagmus. An angio-MRI was performed and revealed hyper-signal images in the aqueduct in the aqueduct of Sylvius, in favor of a Gayet-Wernicke encephalopathy. After three days of systemic vitamin therapy for three days, the evolution was spectacular and the patient was discharged home after 7 days. Conclusions: It is of paramount importance to remind all practitioners that they should always suspect Gayet-Wernicke encephalopathy in the presence of any confusion or oculomotor sign in a pregnant woman with vomiting in pregnancy, and also to underline the importance of prevention by systematically prescribing of vitamin B1 in any pregnant woman with hyperemesis gravidarum.