Wernicke’s Encephalopathy (WE) Associated with Hyperemesis Gravidarum (HG) Presenting with Psychiatric Morbidity: Description of Two Cases

Abstract

Background:Hyperemesis gravidarum (HG) refers to intractable vomiting during pregnancy and is rarely associated with Wernicke’s encephalopathy (WE). HG-associated WE can lead to mortality and permanent cognitive impairment if left untreated. In this report, we present two cases of WE following HG occurring in the context of comorbid severe depression.Case Description:In the first case, a 29-year-old female developed HG and WE during the second month of pregnancy, followed by an episode of severe depression with catatonia. In the second case, a 23-year-old female with bipolar disorder presented with HG for two months during pregnancy, followed by an episode of severe depression and a fractured mandible due to a fall.Conclusion:Thiamine should be considered in women experiencing prolonged vomiting during pregnancy, and they should be closely monitored for features of WE.