Hyperemesis gravidarum-induced Wernicke's encephalopathy

Wernicke's encephalopathy is a potentially fatal but readily reversible medical emergency caused by thiamine deficiency. A 30-year-old, 14 weeks pregnant South Indian woman presented with confusion, diplopia, blurring of vision, gait ataxia, nystagmus and conjugate gaze palsy with a background of intractable hyperemesis gravidarum. With clinical suspicion and radiological confirmation, she was diagnosed to have Wernicke's encephalopathy. Immediate intervention with parenteral thiamine restored her neurological status with amelioration of nystagmus, diplopia and ataxia without any neurological sequelae. Here we report this case to illustrate the importance of early recognition of this extremely rare illness in order to avoid permanent neurological deficit.