Abstract：
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\'s 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.
摘要：
一名20多岁的孕妇在怀孕17周时，出现无痛性视力减退的症状，之前有8周的妊娠剧吐史。在检查中，她很困惑,迷失方向，有步态共济失调，双眼视力完全丧失。眼底检查显示4级椎间盘水肿伴浅表视网膜出血。保留的可能性是脑静脉窦血栓形成，视神经脊髓炎谱系障碍，后部可逆性脑病综合征和韦尼克脑病（WE）。硫胺素水平低。MRI脑部MR静脉造影显示双侧内侧丘脑对称的高信号区域，下丘脑,乳头体和后区。在治疗后2周内，她接受了静脉内硫胺素的治疗，并获得了完全的临床和放射学分辨率。因此,我们得出的结论是,在适当的临床环境中对WE的高怀疑指数导致早期治疗,可能会逆转其严重的临床症状和并发症.
