Kreutzer Beth, Buehrer Blake, Pelikan Andrew, Rohde Phillip
University of Missouri, Department of Emergency Medicine, Columbia, Missouri.
Clin Pract Cases Emerg Med. 2024 Nov;8(4):357-360. doi: 10.5811/cpcem.20522.
Wernicke encephalopathy is a clinical diagnosis that requires a high degree of clinical suspicion to recognize. We report a case of a pregnant patient developing Wernicke encephalopathy in the setting of severe hyperemesis gravidarum.
The patient was a 22-year-old female 13 weeks pregnant presenting to the emergency department (ED) with neurological deficits after several weeks of hyperemesis gravidarum requiring hospitalization. Exam and workup ultimately revealed the diagnosis of Wernicke encephalopathy. Her symptoms improved after administration of thiamine.
Wernicke encephalopathy is a consequence of thiamine deficiency, commonly seen in patients with alcohol use disorder but also with other causes of nutritional deficiency, such as hyperemesis gravidarum. Wernicke encephalopathy is a clinical diagnosis that requires a high degree of suspicion and is, therefore, often missed in the ED setting. Treatment is supplemental thiamine and management of the root cause for nutritional deficiency.
韦尼克脑病是一种临床诊断，需要高度的临床怀疑才能识别。我们报告一例妊娠剧吐患者发生韦尼克脑病的病例。
该患者为一名22岁、孕13周的女性，因妊娠剧吐数周并需要住院治疗，后出现神经功能缺损而就诊于急诊科。检查和检查最终确诊为韦尼克脑病。给予硫胺素后，她的症状有所改善。
韦尼克脑病是硫胺素缺乏的结果，常见于酒精使用障碍患者，但也见于其他营养缺乏原因，如妊娠剧吐。韦尼克脑病是一种临床诊断，需要高度怀疑，因此在急诊科环境中常常被漏诊。治疗方法是补充硫胺素并处理营养缺乏的根本原因。
