Sulaiman Wahinuddin, Othman Azerin, Mohamad Monniaty, Salleh Hj Rosemi, Mushahar Lily
Department of Medicine, Hospital Kota Bharu, 15586 Kota Bharu, Kelantan, Malaysia.
Malays J Med Sci. 2002 Jul;9(2):43-6.
Two cases of Wernicke's encephalopathy due to hyperemesis gravidarum are described. The first patient presented with bilateral papilloedema, altered sensorium and the second with bilateral retinal haemorrhages, ophthalmoplegia and nystagmus. Both patients were diagnosed with Wernicke's encephalopathy on clinical ground since there were no laboratory facilities to measure red cell transketolase and thiamine pyrophosphate levels. This is a rare but treatable complication of hyperemesis gravidarum (HG) and due to lack of diagnostic tools, there is often diagnostic uncertainty, delay in commencing appropriate treatment, as well as irreversible damage to the upper brain stem and death.
本文描述了两例因妊娠剧吐导致的韦尼克脑病病例。首例患者表现为双侧视乳头水肿、意识改变，第二例患者表现为双侧视网膜出血、眼肌麻痹和眼球震颤。由于当时没有实验室设施来检测红细胞转酮醇酶和硫胺素焦磷酸水平，两名患者均根据临床症状被诊断为韦尼克脑病。这是妊娠剧吐（HG）一种罕见但可治疗的并发症，由于缺乏诊断工具，常常存在诊断不确定性，导致开始适当治疗的延迟，以及上脑干的不可逆损伤甚至死亡。
