1/4. memory loss and ataxia after hyperemesis gravidarum: a case of Wernicke-korsakoff syndrome.hyperemesis gravidarum can induce Wernicke-korsakoff syndrome (WKS), a thiamin deficiency disorder characterized by ocular abnormalities, ataxia and disturbance of consciousness. This should be considered in the differential diagnosis of pregnant patients with persisting vomiting and neurological alterations.- - - - - - - - - - ranking = 1keywords = consciousness (Clic here for more details about this article) |
2/4. Pneumomediastinum following esophageal rupture associated with hyperemesis gravidarum.A patient was diagnosed with pneumomediastinum caused by an esophageal rupture during hyperemesis gravidarum. The woman, at 15 weeks' gestation, presented with hyperemesis gravidarum complicated by an episode of chest pain and disturbance of consciousness. Radiological examination revealed pneumomediastinum and subcutaneous emphysema. They are normally caused by either pulmonary or esophageal rupture. The esophageal etiology was suspected as more likely because of the severe vomiting accompanied with it. Although the clinical feature was quite complicated and esophageal rupture is generally a life-threatening disease, we chose conservative therapy which resulted in rapid recovery. The final diagnosis was confirmed by endoscopic examination performed after recovery. Pneumomediastinum during pregnancy is rare but it could be lethal. Careful and considerate assessments including surgical treatment should be necessary.- - - - - - - - - - ranking = 1keywords = consciousness (Clic here for more details about this article) |
3/4. hyperemesis gravidarum complicated by wernicke encephalopathy: background, case report, and review of the literature.wernicke encephalopathy (WE) is a rare but known complication of severe hyperemesis gravidarum caused by thiamine deficiency. This article presents an unusual case that occurred at our institution and reviews the 48 previously published cases of WE in pregnancy. Considering all the 49 cases, the mean ( /-standard deviation) patients' age was 26.7 /- 4.9 years, the mean gestational age when WE manifested was 14.3 /- 3.4 weeks, and the mean duration of vomiting and feeding difficulties was 7.7 /- 2.8 weeks. Wernicke's classic triad (confusion, ocular abnormalities, and ataxia) manifested in only 46.9% (23 of 49) of the patients. confusion affected 63.3% (31 of 49) of the patients, ocular signs 95.9% (47 of 49) and symptoms 57.1% (28 of 49), and ataxia 81.6% (40 of 49). Deterioration of consciousness affected 53.1% (26 of 49) of the subjects and memory impairment 61.2% (30 of 49). Complete remission of the disease occurred in only 14 of 49 cases. Symptom resolution required months and permanent impairments were common. The overall pregnancy loss rate, directly (spontaneous fetal loss) and indirectly (planned abortion) attributable to WE, was 47.9% (23 of 49). The diagnosis of WE is clinical and can be rapidly confirmed by magnetic resonance imaging. We emphasize the importance of thiamine supplementation to women with prolonged vomiting in pregnancy, especially before intravenous or parenteral nutrition. We also underline the necessity to promptly replace vitamin B1 when neurologic symptoms and/or signs develop in a patient with hyperemesis gravidarum.- - - - - - - - - - ranking = 1keywords = consciousness (Clic here for more details about this article) |
4/4. Acute Wernicke's encephalopathy associated with hyperemesis gravidarum: magnetic resonance imaging findings.A 25-year-old woman with hyperemesis gravidarum developed acute Wernicke's encephalopathy during prolonged intravenous fluid therapy without vitamin supplements. Delay in diagnosis led to a persistent severe neurological deficit, including coma. gadolinium-diethylenetriaminepentaacetic acid-enhanced magnetic resonance imaging revealed symmetrical lesions around the aqueduct and fourth ventricle, which resolved after treatment with thiamine. She did not regain consciousness. This report demonstrates the diagnostic value of enhanced magnetic resonance imaging in acute Wernicke's encephalopathy.- - - - - - - - - - ranking = 1keywords = consciousness (Clic here for more details about this article) |