Abstract
We report a case of a 26-year-old pregnant woman, who presented with subacute limb weakness. This was initially suspected to be Guillain-Barre syndrome but subsequently found to be the motor neuropathy of dry beriberi (vitamin B1, thiamine deficiency) along with associated Wernicke’s encephalopathy (WE). The underlying cause was revealed as hyperemesis gravidarum (HG). HG complicates up to 3% of pregnancies and if severe, without nutritional supplements, may lead to electrolyte disturbances, calorie loss and vitamin deficiency. Although the association of HG and WE was first reported in 1939, it remains an under diagnosed condition with potential for serious and permanent neurological deficits, and some mortality, in both mother and baby. Early recognition of the problem, with timely and careful fluid, electrolyte, glucose and vitamin replacement is needed to avoid complications. We highlight current best practice in the treatment of WE. An open mind to the possibility of HG complications in any pregnant woman presenting with neurological symptoms is probably the most important lesson to learn from the front line.
Reference21 articles.
1. Metabolic and Structural Role of Thiamine in Nervous Tissues
2. Thiamine in Nutrition Therapy
3. Thiamine levels during intensive insulin therapy in critically ill patients;van Snippenburg;J Intensive Care Med,2017
4. Baynes JW , Dominiczak MH . Medical biochemistry. Philadelphia: Elsevier Mosby, 2005.
5. Daroff RB , Jankovic J , Mazziotta JC . Bradley’s neurology in clinical practice. 7 edn. London, New York: Elsevier, 2016.
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献