Abstract
Hyperemesis gravidarum can impair correct absorption of an adequate amount of thiamine and can cause electrolyte imbalance. This study investigated the neurological complications in a pregnant woman with hyperemesis gravidarum. A 29-year-old pregnant woman was admitted for hyperemesis gravidarum. Besides undernutrition, a neurological examination disclosed weakness with hyporeflexia, ophthalmoparesis, multidirectional nystagmus and optic disks swelling; the patient became rapidly comatose. Brain MRI showed symmetric signal hyperintensity and swelling of periaqueductal area, hypothalamus and mammillary bodies, medial and posterior portions of the thalamus and columns of fornix, consistent with Wernicke encephalopathy (WE). Neurophysiological studies revealed an axonal sensory-motor polyneuropathy, likely due to thiamine deficiency or critical illness polyneuropathy. Sodium and potassium supplementation and parenteral thiamine were administered with improvement of consciousness state in a few days. WE evolved in Korsakoff syndrome. A repeat MRI showed a marked improvement of WE-related alterations and a new hyperintense lesion in the pons, suggestive of central pontine myelinolysis. No sign or symptom due to involvement of the pons was present.
| Original language | English |
|---|---|
| Pages (from-to) | 133-135 |
| Number of pages | 3 |
| Journal | Neurological Sciences |
| Volume | 33 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Feb 2012 |
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Keywords
- Central pontine myelinolysis
- Hyperemesis gravidarum
- Korsakoff syndrome
- Thiamine deficiency
- Wernicke encephalopathy
ASJC Scopus subject areas
- Clinical Neurology
- Psychiatry and Mental health
- Dermatology
Cite this
Neurological complications in hyperemesis gravidarum. / Zara, Gabriella; Codemo, Valentina; Palmieri, Arianna; Schiff, Sami; Cagnin, Annachiara; Citton, Valentina; Manara, Renzo.
In: Neurological Sciences, Vol. 33, No. 1, 02.2012, p. 133-135.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Neurological complications in hyperemesis gravidarum
AU - Zara, Gabriella
AU - Codemo, Valentina
AU - Palmieri, Arianna
AU - Schiff, Sami
AU - Cagnin, Annachiara
AU - Citton, Valentina
AU - Manara, Renzo
PY - 2012/2
Y1 - 2012/2
N2 - Hyperemesis gravidarum can impair correct absorption of an adequate amount of thiamine and can cause electrolyte imbalance. This study investigated the neurological complications in a pregnant woman with hyperemesis gravidarum. A 29-year-old pregnant woman was admitted for hyperemesis gravidarum. Besides undernutrition, a neurological examination disclosed weakness with hyporeflexia, ophthalmoparesis, multidirectional nystagmus and optic disks swelling; the patient became rapidly comatose. Brain MRI showed symmetric signal hyperintensity and swelling of periaqueductal area, hypothalamus and mammillary bodies, medial and posterior portions of the thalamus and columns of fornix, consistent with Wernicke encephalopathy (WE). Neurophysiological studies revealed an axonal sensory-motor polyneuropathy, likely due to thiamine deficiency or critical illness polyneuropathy. Sodium and potassium supplementation and parenteral thiamine were administered with improvement of consciousness state in a few days. WE evolved in Korsakoff syndrome. A repeat MRI showed a marked improvement of WE-related alterations and a new hyperintense lesion in the pons, suggestive of central pontine myelinolysis. No sign or symptom due to involvement of the pons was present.
AB - Hyperemesis gravidarum can impair correct absorption of an adequate amount of thiamine and can cause electrolyte imbalance. This study investigated the neurological complications in a pregnant woman with hyperemesis gravidarum. A 29-year-old pregnant woman was admitted for hyperemesis gravidarum. Besides undernutrition, a neurological examination disclosed weakness with hyporeflexia, ophthalmoparesis, multidirectional nystagmus and optic disks swelling; the patient became rapidly comatose. Brain MRI showed symmetric signal hyperintensity and swelling of periaqueductal area, hypothalamus and mammillary bodies, medial and posterior portions of the thalamus and columns of fornix, consistent with Wernicke encephalopathy (WE). Neurophysiological studies revealed an axonal sensory-motor polyneuropathy, likely due to thiamine deficiency or critical illness polyneuropathy. Sodium and potassium supplementation and parenteral thiamine were administered with improvement of consciousness state in a few days. WE evolved in Korsakoff syndrome. A repeat MRI showed a marked improvement of WE-related alterations and a new hyperintense lesion in the pons, suggestive of central pontine myelinolysis. No sign or symptom due to involvement of the pons was present.
KW - Central pontine myelinolysis
KW - Hyperemesis gravidarum
KW - Korsakoff syndrome
KW - Thiamine deficiency
KW - Wernicke encephalopathy
UR - http://www.scopus.com/inward/record.url?scp=84862210720&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84862210720&partnerID=8YFLogxK
U2 - 10.1007/s10072-011-0660-y
DO - 10.1007/s10072-011-0660-y
M3 - Article
C2 - 21720901
AN - SCOPUS:84862210720
VL - 33
SP - 133
EP - 135
JO - Neurological Sciences
JF - Neurological Sciences
SN - 1590-1874
IS - 1
ER -