{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T23:09:17Z","timestamp":1793920157737,"version":"4.8.0"},"reference-count":14,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,5,21]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>A pregnant woman in her 20s at 17 weeks of gestation, presented with symptoms of painless diminution of vision preceded by 8 weeks history of hyperemesis gravidarum. On examination, she was confused, disoriented and had gait ataxia with complete loss of vision in both eyes. Fundus examination revealed grade 4 disc oedema with superficial retinal haemorrhages. Possibilities kept were cerebral venous sinus thrombosis, neuromyelitis optica spectrum disorder, posterior reversible encephalopathy syndrome and Wernicke\u2019s encephalopathy (WE). Thiamine levels were low. MRI brain with MR venography revealed symmetrical areas of hyperintensities in bilateral medial thalami, hypothalamus, mammillary body and area postrema. She was managed as a case of WE with intravenous thiamine with complete clinical and radiological resolution within 2 weeks of treatment. Therefore, we conclude that a high index of suspicion of WE in appropriate clinical settings leading to early treatment can potentially reverse its grave clinical symptoms and complications.<\/jats:p>","DOI":"10.1136\/bcr-2024-259840","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:10:15Z","timestamp":1717027815000},"page":"e259840","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Visual loss and encephalopathy in a pregnant patient with hyperemesis gravidarum"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8065-3428","authenticated-orcid":false,"given":"Purushottam","family":"Singh","sequence":"first","affiliation":[{"name":"Neurology, Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Gupta","sequence":"additional","affiliation":[{"name":"Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anirban","family":"Gupta","sequence":"additional","affiliation":[{"name":"Neurology, Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shashikala","family":"Turlapati Padmavathi","sequence":"additional","affiliation":[{"name":"Neurology, Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,5,29]]},"reference":[{"key":"2025082800185799000_17.5.e259840.1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2010.16"},{"key":"2025082800185799000_17.5.e259840.2","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/BF00142696","article-title":"Optic neuropathy from thiamine deficiency in a patient with ulcerative colitis","volume":"67","author":"van Noort","year":"1987","journal-title":"Doc Ophthalmol"},{"key":"2025082800185799000_17.5.e259840.3","first-page":"10","article-title":"Wernicke\u2019s encephalopathy: increasing clinician awareness of this serious, enigmatic, yet treatable disease","volume":"17","author":"Flynn","year":"2015","journal-title":"Prim Care Companion CNS Disord"},{"key":"2025082800185799000_17.5.e259840.4","doi-asserted-by":"crossref","first-page":"260","DOI":"10.4103\/0022-3859.191005","article-title":"Wernicke\u2019s encephalopathy due to Hyperemesis Gravidarum: clinical and magnetic resonance imaging characteristics","volume":"62","author":"Ashraf","year":"2016","journal-title":"J Postgrad Med"},{"key":"2025082800185799000_17.5.e259840.5","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.49.4.341"},{"key":"2025082800185799000_17.5.e259840.6","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0b013e3181ceb4d0"},{"key":"2025082800185799000_17.5.e259840.7","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.survophthal.2005.04.005","article-title":"You are what you eat","volume":"50","author":"Kulkarni","year":"2005","journal-title":"Surv Ophthalmol"},{"key":"2025082800185799000_17.5.e259840.8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/S0140-6736(47)91272-5","article-title":"Cerebral beriberi (Wernicke\u2019s encephalopathy); 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