Korean J Ophthalmol.  2005 Sep;19(3):239-242. 10.3341/kjo.2005.19.3.239.

Wernicke-Korsakoff Syndrome Associated with Hyperemesis Gravidarum

• Yoon CK
• Chang MH
• Lee DC

• KMID: 754432
• DOI: http://doi.org/10.3341/kjo.2005.19.3.239

Abstract

PURPOSE
The authors hereby describe a case of Wernicke-Korsakoff syndrome with accompanying ocular findings that is caused by hyperernesis gravidarum. METHODS: We experienced a 27-year-old female at 12 weeks of pregnancy, who visited our clinic because of weight loss, gait disturbance, decreased mentality and dizziness after prolonged vomiting for 2 months. Neurological examination demonstrated ataxia of gait and loss of orientation. Ophthalmologic examination showed decreased visual acuity, upbeat nystagmus, diplopia and retinal hemorrhage. RESULTS: We report a relatively rare case of Wernicke-Korsakoff syndrome with ophthalmic symptoms induced by hyperemesis gravidarum. CONCLUSIONS: If a pregnant women has symptoms of severe vomiting along with other ocular findings such as retinal hemorrhage or restricted extraocular movement, one must suspect the diagnosis of Wernicke-Korsakoff syndrome, and should start appropriate treatment immediately.

Keyword

Hyperemesis gravidarum; Pregnancy; Retinal hemorrhage; Thiamine deficiency; Wernicke-Korsakoff syndrome

MeSH Terms

Vision Disorders/*etiology
*Pregnancy Complications
Pregnancy
Korsakoff Syndrome/*etiology/*physiopathology
*Hyperemesis Gravidarum
Humans
Female
Eye Diseases/*etiology
Adult

Figure

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  Fig. 1 MRI result (T2-weighted image, A) showing high signal changes in both medial thalami, 3rd ventricle, and periaqueductal white matter (arrow), and diffusion weighted image (DWI, B) with the lesions showing bilateral and symmetrical high signal intensity.

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  Fig. 2 Fundus examination revealing peripapillary retinal hemorrhage in the right eye and slightly pale features in both optic discs. The amount of hemorrhage was less severe in her left eye which had completely disappeared after three days when color photos of her eyes were taken.

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  Fig. 3 Visual evoked potential (VEP) showing increased latency and decreased amplitude in her left eye.

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