Introduction:

Hyperemesis gravidarum causes potentially lethal neurological complications such as Wernicke's encephalopathy, an acute disease due to vitamin B1 deficiency in the brain.

Objective:

To present an unusual clinical case of Wernicke encephalopathy, as a complication of hyperemesis gravidarum.

Clinical case:

42-year-old patient with a 12.4-week gestation who was admitted for hyperemesis gravidarum and later transferred to the intensive care unit. Neurology assessment was requested when referring to dizziness, blurred vision and incoordination of movements. On physical examination, she presented drowsiness, bradypsychia, disorientation in time and space, bilateral horizontal and rotatory nystagmus, and trunk ataxia. Magnetic resonance imaging showed hyperintensity of signals in the thalamus, around the third ventricle, in the fornix, cortex and cerebral subcortex. Wernicke encephalopathy secondary to hyperemesis gravidarum was considered. The patient evolved favorably with the administration of vitamin B1 and steroids.

Conclusions:

The association between hyperemesis gravidarum and Wernicke encephalopathy is rare, but with serious consequences. Prompt diagnosis and treatment are essential to reduce the risk of sequelae.

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