Wernicke's encephalopathy secondary to gestational hyperthyroidism

Abstract

Background: Wernicke's encephalopathy is a neurological disorder secondary to the deficiency of vitamin B1 (thiamine). The classic symptoms consist of nystagmus, ophthalmoplegia, ataxia and mental status changes. Initially, this was described by Carl Wernicke in 1881 as acute haemorrhagic polioencephalitis. Wernicke's encephalopathy is mostly described in association with malnutrition and alcoholism. However, it has been increasingly being noted in various other settings. There is also evidence that this may be an underdiagnosed condition as several cases may not manifest the classical triad of symptoms. Prompt diagnosis and treatment are essential as any delay or undertreatment can result in irreversible complications. We report a case of gestational hyperthyroidism causing Wernicke's encephalopathy. To our knowledge, there have been only four previous cases of gestational hyperthyroidism causing Wernicke's encephalopathy in the literature.