Abstract:

Wernicke encephalopathy (WE) is a less frequently occurring but severe neurological disorder resulting from thiamine deficiency. Chronic alcoholism is the most common and serious risk factor for Wernicke encephalopathy. However, nonalcoholic causes like hyperemesis gravidarum also induce WE. Besides, the clinical presentations and early diagnosis of the disease are often challenging but essential to avoid severe maternal and fetal complications. In our investigation, we report two cases of pregnant women with persistent vomiting and neurological symptoms, including abnormal eye movements and gait disturbances. Both patients were diagnosed with WE based on clinical findings and MRI evidence of characteristic periaqueductal lesions. Prompt administration of high-dose intravenous thiamine resulted in significant clinical improvement, with symptom resolution and successful transition to oral thiamine therapy. These cases highlight the importance of considering Wernicke encephalopathy in pregnant women with prolonged vomiting. Early recognition and treatment with thiamine can prevent severe neurological complications and improve maternal and fetal outcomes.

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